When something hurts, it’s natural to wonder whether you need an X-ray, ultrasound or MRI to find out what’s going on.
Sometimes a scan is very helpful. But for many common muscle and joint problems, a good clinical assessment can tell us much of what we need to know – and a scan may not change the treatment at all.
What can scans tell us?
Different types of imaging are useful for different things:
X-rays are particularly useful for looking at bones and joints, including fractures and changes associated with arthritis.
Ultrasound can help assess certain tendons, muscles and other soft tissues, particularly when there is a specific structure we want to investigate. Because ultrasound provides real-time imaging while you move, it can also be particularly useful for investigating mechanical problems – allowing the clinician to see how structures behave during movement rather than only viewing a static image
MRI provides detailed images of joints and soft tissues and can be very useful when a significant injury is suspected, symptoms aren’t progressing as expected, or the result is likely to influence treatment.
Why not scan everything?
One of the challenges with imaging is that scans often find changes that aren’t actually causing pain.
Things such as disc bulges, tendon changes, cartilage wear and arthritis can be seen on scans in people who have little or no pain at all.
This means a scan result needs to be considered alongside your symptoms, history and physical examination. Finding something on a scan doesn’t necessarily mean it is the source of the problem. It’s always important that your doctor or physiotherapist discuss scan findings with you so you can understand what are normal changes and what could be a cause of your symptoms.
Assessment often comes first
For many common problems – including back pain, neck pain, shoulder pain, tendon problems, knee or hip complaints – your physiotherapist can assess your movement, strength, function and symptoms to help determine what is most likely happening.
From there, we can decide whether treatment can begin straight away or whether further investigation would be helpful.
So, when might you need a scan?
Imaging may be appropriate when there has been significant trauma, a fracture or serious injury is suspected, symptoms are unusual or worsening, you’re not recovering as expected, or the result would change how the problem is managed.
The important question isn’t simply “Can we scan it?”
It’s “Will a scan give us useful information that changes what we do next?”
If you have a new or persistent injury and aren’t sure whether you need imaging, a physiotherapy assessment can be a good place to start.
We look forward to helping you keep moving.
