DO YOU NEED AN MRI?

In all cases of arthritis, x-rays are very useful as the first imaging test.  Often, x-rays will be the only test needed to assess the health of a joint.  There are situations when more imaging is needed.  Depending on what the concern is, your doctor may order an MRI, CT scan, ultrasound, or bone scan. 

MRI is known by patients as the “best test to see what is really going on”.  Despite its legendary status, MRI is not always the best test, but it is commonly ordered when more imaging than x-ray is needed.  Whereas x-ray can only visualize bones, MRI can also see soft tissue such as ligaments, tendons, and muscles.  MRI provides a 3-dimensional assessment that looks through the body from front to back and side to side, while x-ray provides a “flat” picture which is basically an outline of the bones. 

Your doctor may order x-rays to check joint structure when you have pain or loss of function.  There are a few reasons for ordering more tests:

The x-ray is normal but your joint pain is severe

If your x-ray is normal or the arthritis visible on your x-ray does not explain your severe pain, your doctor may choose more detailed imaging tests to visualize the joint better.

You have pain that is not from arthritis

If the bones and joints seem OK based on your symptoms, examination, and x-rays, then your doctor may need to order further testing to evaluate for tears in your tendons, ligaments, or muscles. 

The x-ray shows a possible abnormality

Sometimes, an x-ray will “see” something that may be suspicious.  Further testing will be needed to better define the area of concern to help come up with a diagnosis.