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.

A Bankart lesion is a tear of the labrum, the ring of cartilage that encircles the shoulder joint socket, that can occur when the shoulder is dislocated. This injury frequently affects young athletes and is associated with shoulder instability. This review was performed to provide an overview of anterior shoulder instability, with an emphasis on rehabilitation and the return to sports following arthroscopic Bankart repair. We searched the Google Scholar and PubMed academic databases through February 18th, 2024, utilizing keywords including “arthroscopic Bankart repair” and “return to sports”. Our findings indicate that athletes who undergo arthroscopic Bankart repair exhibit higher rates of returning to sports compared to those who receive other anterior shoulder stabilization procedures. Several factors are considered when determining readiness to return to athletics, including time elapsed since surgery, type of sport, strength, range of motion, pain, and proprioception. Surgeons typically advise athletes to wait approximately 6 months after surgery before resuming sports activities. They also recommend that athletes regain at least 80% of the strength of the uninjured shoulder or achieve strength levels comparable to those prior to the injury. Additionally, patients are expected to attain a full range of motion without pain, which should be symmetrical to the uninjured side, and demonstrate improved proprioception in the shoulder. The sport in which an athlete participates can also influence the timeline for return. Those involved in overhead sports, like baseball or tennis, often experience lower success rates in returning to their sport compared to athletes from other disciplines.