Scan results: Why so many 'abnormal' findings are normal with age
You've had a scan. The report comes back with words like tear, degeneration, bulge or fraying, and suddenly your shoulder or back feels like something that's broken. Here is a number worth knowing before you read that report again. Earlier this year, researchers in Finland scanned both shoulders of 602 adults aged 41 to 76, chosen at random from the general population. 99% had changes in their rotator cuff. Most of them had no shoulder pain at all.
Changes on scans are extremely common, and they become more common as we get older. Think of them as the inside version of grey hair and wrinkles. Plenty of them have nothing to do with pain.
What do scan results actually show?
A scan (an X-ray, ultrasound, CT, or MRI) shows what your tissues look like on one particular day. It can't measure pain. It can't tell you how strong you are, how stiff you are, or how well a shoulder or knee does its job.
Over the past 30 years, researchers have scanned thousands of people with no pain at all. The same findings that appear in the reports of people with pain turn up again and again in people who feel completely fine. So how common are these changes?
Shoulders
In the Finnish study (published in JAMA Internal Medicine in 2026), rotator cuff changes showed up in 96% of shoulders that didn't hurt. The rotator cuff is the group of four tendons that hold the ball of your shoulder in its socket.
Even full-thickness tears (a gap right through the tendon) were common. 11% of people had one, rising to 28% in people aged 70 and over. 78% of all the full-thickness tears found were in shoulders with no pain.
The researchers went further. They suggested that many of these findings are normal age-related changes, and that reports should use less alarming words than "tear", which suggests trauma, which may not have happened.
Spine
A review of 33 studies looked at the scans of 3,110 people with no back pain.
Disc degeneration (discs losing water and height over time) was found in:
37% of 20-year-olds
80% of 50-year-olds
96% of 80-year-olds
Disc bulges followed the same pattern, rising from 30% at age 20 to 84% at age 80. The authors concluded that many of these features are likely part of normal ageing.
Hips
The labrum is a rim of cartilage around the hip socket.
A 2018 review found labral tears in 54% of people with no hip pain.
Knees
From age 40, 19% of pain-free, uninjured knees had a meniscal tear and 43% had cartilage changes on MRI. The meniscus is the C-shaped cushion inside the knee.
A large American study of people aged 50 to 90 found that 61% of those with a meniscal tear had no knee pain in the previous month.
Hands
In a 2022 study of 3,588 people, 41% had osteoarthritis in their hands on X-ray. Only 12% had painful hand osteoarthritis.
Do scan findings ever matter?
Yes. Some findings are more common in people with pain, and an honest picture includes them.
In the Finnish shoulder study, full-thickness tears were more common in painful shoulders (14.6% vs 6.5%). That gap mostly disappeared once the researchers accounted for other findings and the clinical examination.
In adults aged 50 and under, disc bulges, protrusions and extrusions are more common in people with back pain. Extrusions (where disc material pushes further out) are rare in people without pain.
Hip labral tears are a little more common in people with hip pain (62% vs 54%).
Scans also have a clear place. After a significant fall or accident, when symptoms don't fit the usual pattern, when medical causes need ruling out, or when a surgical decision depends on the result, imaging can give important information. Your physio, osteo, or GP will talk to you about whether a scan is likely to change what happens next.
Why the words in your report matter
Scan reports are written by radiologists for other clinicians. Words like "degeneration" and "tear" are standard medical shorthand. Read without context, they sound like damage.
That's why we go through scan reports with patients line by line. A "degenerative disc" in a 55-year-old is what the research expects to find: about 80% of pain-free 50-year-olds have one.
So, what does this mean for you?
If you have pain and a scan report full of these words, the findings might be part of the picture, or they might be unrelated. Working that out takes a proper assessment: your history, how your pain behaves, your strength, how you move and what you want to get back to.
People often improve without the scan finding changing at all. In a 2025 trial of 204 people with lateral hip pain from the gluteal tendons, how severe the tendon changes looked on MRI wasn't linked to pain, function or disability. The trial team recommends education and exercise as the first treatment, including when tears are present.
Your body keeps adapting at every age. Your body is incredible! Tendons, discs and joints respond to the right kind of loading, whatever the scan shows.
How we use scans at Balance Health
We assess first. We refer for imaging when the result is likely to change your treatment, and we work with your GP when it is. If you already have a scan, bring the report along and we'll go through it with you in language your can understand
This article is for general education only and is not a substitute for personalised medical advice.
References
Ibounig T, et al. Incidental rotator cuff abnormalities on magnetic resonance imaging. JAMA Intern Med. 2026;186(4):406-414.
Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. 2015;36(4):811-816.
Brinjikji W, et al. MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls. AJNR. 2015;36(12):2394.
Heerey JJ, et al. Prevalence of intra-articular hip pathologies in people with and without pain. Br J Sports Med. 2018;52(9):581.
Culvenor AG, et al. Prevalence of knee osteoarthritis features on MRI in asymptomatic uninjured adults. Br J Sports Med. 2019;53(20):1268.
Englund M, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 2008;359(11):1108-1115.
Eaton CB, et al. Prevalence, incidence, and progression of radiographic and symptomatic hand osteoarthritis. Arthritis Rheumatol. 2022;74(6):992-1000.
LEAP trial investigators. Imaging findings in patients with clinically diagnosed gluteal tendinopathy. Arch Orthop Trauma Surg. 2025;145:347.
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