Prevalence and Grading of Rotator Cuff Tears and Labral Injuries in Patients with Shoulder Pain and Instability: An MRI-Based Cross-Sectional Study

Abstract

BACKGROUND: Shoulder pain and instability are among the most prevalent musculoskeletal complaints worldwide, significantly impairing daily function and quality of life. Rotator cuff tears and labral injuries constitute the dominant underlying pathologies, yet their precise prevalence, grading, and demographic distribution remain incompletely characterised in the Indian population. Magnetic resonance imaging (MRI) is the gold-standard non-invasive modality for shoulder soft-tissue evaluation, offering superior contrast resolution and multiplanar capability without ionising radiation.

OBJECTIVES: To determine the prevalence and MRI-based grading of rotator cuff tears and labral injuries in patients presenting with shoulder pain and instability; to describe the demographic distribution by age, sex, and occupation; and to examine the association of metabolic comorbidities with pathology severity.

METHODS: A hospital-based cross-sectional study was conducted over 12 months (December 2023–December 2024) at the Department of Radiodiagnosis, Dr. Prabhakar Kore Hospital and Research Centre, Belagavi. Eighty-one consecutive patients (aged 20–75 years) referred from Orthopaedics with shoulder pain or instability underwent standardised 1.5T MRI. Rotator cuff tears were classified by thickness, size, tendon retraction, muscle atrophy, and Fuchs fatty-infiltration grade. Labral pathology was categorised as Bankart, bony Bankart, SLAP, Perthes, reverse Bankart, and reverse Hill-Sachs lesions. Statistical analysis included Chi-square, Fisher's exact test, and descriptive statistics; p < 0.05 was considered significant.

RESULTS: Of 81 patients, 42 (51.9%) were male and 39 (48.1%) female; mean age was 54.95 ± 9.07 years. Partial-thickness rotator cuff tears (n = 19) showed male predominance (57.9%), while complete tears (n = 15) were more frequent in females (60.0%). Forty-seven patients had other pathologies including SLAP tears (n = 15) and tendinosis/bursitis/impingement (n = 32). Rotator cuff tears were most prevalent in the 50–59 year age group (36.4%). Farmers exhibited the highest combined tear burden (partial + complete: n = 19). Diabetes mellitus was the most common comorbidity (43.2% overall; 73.7% of the partial-tear group).

CONCLUSION: MRI reliably characterised the full spectrum of shoulder pathology. Rotator cuff disease predominantly affects middle-aged individuals with physically demanding occupations, and metabolic comorbidities—particularly diabetes mellitus—are strongly associated. These findings underscore the necessity of integrating MRI assessment with demographic and comorbidity profiling for optimal clinical decision-making.