Glenohumeral Pathology Seen at the Time of Diagnostic Arthroscopy After Normal Magnetic Resonance Imaging

Despite studies highlighting magnetic resonance imaging (MRI)/magnetic resonance angiogram (MRA) accuracy in diagnosing shoulder pathologies, there remains a paucity of data regarding false negative results of these tests. The authors retrospectively characterized demographic and intraoperative data of 34 patients (19 male, 15 female; average age 23 years), the majority with atraumatic dominant shoulder pain, who underwent diagnostic shoulder arthroscopy after normal preoperative MRI/MRA as read by a board-certified musculoskeletal radiologist. Patients averaged 426 days from first clinic visit and 266 days from MRI until surgical intervention. Modern imaging does not accurately diagnose shoulder injuries in a small subset of patients who tend to be younger and have a clinical history of atraumatic pain in their dominant shoulder. Posterior labral tears and capsular laxity were the most encountered intraoperative pathologies. Careful and thorough clinical history and physical examination are necessary, as are the use of imaging technologies as adjuvant rather than conclusive diagnostic tools for shoulder injuries. (Journal of Surgical Orthopaedic Advances 35(2):098–102, 2026)

Key words: shoulder pain, shoulder, MRI, arthroscopy