OBJECTIVE: Shoulder injuries in rugby players are common due to frequent high-impact collisions and tackles. This study aimed to describe the spectrum and pattern of shoulder MRI findings in professional rugby players. METHODS: Single-center retrospective study of shoulder MRI was carried out between 2012 and 2016 in symptomatic professional male rugby league and rugby union players. One hundred ten shoulder MRIs were scored for rotator cuff and long head of biceps tendons, labral, bursal, joint, and osseous abnormalities. MRI features were compared using the chi-square or Fisher's exact tests for categorical variables. RESULTS: There were a total of one hundred ten professional male rugby players (80 rugby league and 30 rugby union), with a mean age of 24.6 (range 17-38) and 23.7 (range 17-33) years old, respectively. Rotator cuff or long head biceps abnormality was found in 36 (33%) players, of which 22 (20%) were either partial or full-thickness tears. Glenoid labral tears were present in 63 (57%) players. There was no significant difference (p >
0.05) in the frequency of tears of the superior (24%), anterior inferior (25%), posterior superior (25%), and posterior inferior (32%) labrum. Forty-seven percent of players presented with two or more abnormalities of the rotator cuff tendons and glenoid labrum. There were significantly more osseous abnormalities in backs compared to forwards (48% vs. 21%
p = 0.01). CONCLUSIONS: There is a wide spectrum of shoulder abnormalities on MRI in professional rugby players, and many have two or more abnormalities. In common with other contact sports, posterior labral injury was a common finding and may relate to sub-clinical trauma, without an association with instability.