Discussion Post - Mri vs X-Ray

Joint injuries in athletes are extremely common. Depending on the sport an athlete participates in, they are more prone to injuring certain areas such as the shoulder, hip and/or knee joint. Once the injury has occurred, they usually seek treatment from their physician. What can the athlete expect to be done to assess his or her injury while at the doctor’s office? Will they need an x-ray or an MRI, or both? How is this decided?

From what I have read, most sports physicians prefer to have the option of taking both x-rays and MRIs of the area in question, because they do very different jobs. They also like to start with an x-ray.

While x-rays just show bones, they are far less costly than an MRI, and they may find the problem without the need for further testing. For example, the x-ray may not see a tear in the ACL, they may see the secondary damage of the small piece of bone pulled off of the lateral tibial plateau. This will tell the physician that there has definitely been an ACL tear, and the need for an MRI is most likely no longer necessary. Another reason for an x-ray is that they can rule out other, less likely scenarios that could be causing the problem such as a tumor or lesion in the bone. One more advantage of an x-ray is that it shows the status of the joint’s health. It can show a meniscal tear or a bone spur, or degenerative changes within the joint.

MRIs are quite different, and much more costly, but just as important. An MRI image shows the soft tissues of the joint such as the ligaments, tendons, muscles, articular cartilage and menisci. It can show changes within the bone, such as bone bruising and swelling within the bone. The sports physicians I gleaned my information from has said that he likes to save the MRIs for cases when the x-ray has come back negative, or he is preparing for surgery on that patient. He added that he likes to try to hold off on the MRI until a more conservative method of ice, rest, anti-inflammatories and...