This review classifies and summarizes the major shoulder diseases affecting older adults, focusing on rotator cuff disease, frozen shoulder, osteoarthritis, and shoulder instability. It explores each condition's pathophysiology, risk factors, clinical presentation, diagnostic approaches, and treatment strategies to guide clinicians in optimizing patient outcomes and enhancing quality of life. Age-related degenerative changes, comorbidities, and distinct etiological factors contribute to the presentation of shoulder disorders in older adults. Rotator cuff disease ranges from tendinopathy to full-thickness tears and is influenced by genetic predispositions, inflammatory cytokines, and muscle quality. Frozen shoulder results from fibroproliferative changes in the capsule, leading to significant pain and restricted motion. Osteoarthritis involves cartilage degeneration and bony remodeling, often necessitating surgical interventions such as arthroplasty. Shoulder instability, though less frequent, is complicated by associated injuries like rotator cuff tears and fractures, requiring tailored management strategies. Advances in imaging techniques, biologic treatments, and surgical procedures, particularly arthroscopic and arthroplasty options, have improved diagnostic accuracy and therapeutic outcomes. A thorough classification of shoulder diseases in older adult patients highlights the complexity of managing these conditions. Effective treatment requires individualized approaches that integrate conservative measures with emerging biologic or surgical therapies. Future research should focus on targeted interventions, standardized diagnostic criteria, and multidisciplinary collaboration to minimize disability, optimize function, and improve overall quality of life in this growing patient population. Multimodal strategies, including patient education, structured rehabilitation, and psychosocial support, further enhance long-term adherence and outcomes. Ongoing vigilance for comorbidities, such as osteoporosis or metabolic disorders, is necessary for comprehensive care.

Shoulder diseases, including adhesive capsulitis, rotator cuff tear, and osteoarthritis of the glenohumeral joint, can significantly impair daily activities in older adult patients. This review aims to examine the radiologic findings associated with these shoulder conditions in older patients, providing insights for accurate diagnosis and effective treatment. Adhesive capsulitis, commonly known as frozen shoulder, leads to pain and restricted movement, thereby causing shoulder dysfunction. Recent advances in diagnostic technology have greatly enhanced the sensitivity and accuracy of diagnosing this condition through radiologic evaluations, including MRI, magnetic resonance arthrography (MRA), and high-resolution ultrasound. Rotator cuff disease is another frequent issue in older adults, with full-thickness tears occurring in 50%–80% of cases. Both MRI and MRA are highly sensitive and specific in identifying rotator cuff tears. Additionally, ultrasonography is recognized for its high sensitivity and specificity in detecting tears of the supraspinatus tendon. Although osteoarthritis of the glenohumeral joint is less commonly prevalent, its advanced stages can severely affect the function of the upper extremity. Plain radiography is typically the first imaging technique used to assess this type of osteoarthritis. As the condition worsens, CT is utilized to measure glenoid bone loss, glenoid version, and inclination, which are crucial for accurate surgical planning. Each imaging modality provides distinct benefits: plain radiographs for initial structural assessment, ultrasonography for real-time evaluation of soft tissues, MRI/MRA for detailed visualization of capsular and tendinous lesions, and CT for precise bony analysis.

The purpose of this review is to provide a comprehensive guide for managing older adult patients with shoulder diseases, specifically rotator cuff tears and osteoarthritis, and to explore effective nonsurgical treatment options. Chronic rotator cuff tears are typically degenerative, whereas acute tears result from trauma. A key feature of these tears is tendon degeneration accompanied by type III collagen predominance, predisposing tears to progression. Osteoarthritis in the glenohumeral joint arises from wear-and-tear changes that compromise cartilage integrity, leading to pain and restricted motion. Accurate clinical assessment and imaging, including plain radiographs, ultrasonography, and MRI, facilitate diagnosis and guide treatment. The physic-al examination emphasizes range of motion, rotator cuff strength, and scapular stability. Management strategies prioritize pain relief, function preservation, and improving mobility. Nonsurgical modalities, including exercise, manual therapy, and activity modification, constitute first-line treatments, especially for older adults. Pharmacological approaches involve NSAIDs, corticosteroid injections, and neuropathic pain medications. Steroid injections have short-term benefits, but repeated treatments may compromise tissue integrity. Platelet-rich plasma is a regenerative option that may improve tendon healing, but mixed findings highlight the need for further investigation. A structured physical therapy program focusing on range of motion and strengthening is essential, with alternative interventions used judiciously. Patients should be counseled regarding the potential progression of tears and the possible need for future surgical intervention if nonsurgical methods are unsuccessful. Multimodal approaches, including joint mobilization and personalized exercise regimens, hold potential for optimizing functional outcomes and supporting independence in older adults.