Imaging and Musculoskeletal Health


There are many types of imaging in healthcare, radiographs (x-rays), MRI’s, ultrasound, and CT Scans being some of the most common. Radiology is the term for imaging. Radiologists are doctors who specialize in analyzing images. Images are used to screen, prevent, and diagnose health conditions.

Is imaging best for you?

Imaging is not a routine, or consistent part of all care plans. Something like a yearly physical is. The most important part of a diagnosis is the information you tell your providers and the physical exams that are performed on you. Imaging can help with diagnosis, but it is not the first step in diagnosis.

Benefits and Risks of Imaging

There are many benefits, but also risks with imaging. A benefit could include early detection of a problem, but the risk could be exposure to radiation (x-ray, bone scan, and CT scan include ionizing radiation). Imaging can be costly. If imaging was ordered regularly without extensive physical examination or a lack of conservative treatment first (physical therapy, massage, chiropractic, acupuncture, etc.), healthcare costs could rise significantly. Imaging can also be a waste of time if it is ordered routinely without high suspicion you will find a positive image (something abnormal in the image).

Indications for Ordering Imaging Sooner than Later

Musculoskeletal conditions, such as shoulder, back, and knee pain can, but usually do not, require imaging prior to physical therapy. An exception would be the suspicion of a broken bone or damaged ligament that can impose a higher threat to your health. An example includes a damaged ligament in your neck after a car accident that can cause compression on the spinal cord. Despite a potentially torn ligament in your knee being extremely painful, because it can be managed with bracing, physical therapy, etc. for a period of time, imaging does not need to be ordered right away.

Can Physical Therapy be performed without imaging?

Yes. Your physical therapist is highly trained to detect what potential injuries are involved. This allows the physical therapist to have enough knowledge to know what to do and what not to do in order to ensure the injury does not get worse. After your initial evaluation, your therapist may express that imaging could be used in the future to confirm the structure(s) involved. This is only indicated if you “fail conservative treatment.” Meaning, you are not normally functional after physical therapy and you may need potential surgery.

Why did my primary care send me to physical therapy before imaging?

Your primary care does not suspect a broken bone, cancer, etc. They may suspect an injury to a structure within your body, but they know that physical therapy could prevent surgery. Because imaging is a precursor to surgery, they want to see if you can get better before guiding you down a more costly, potentially more painful, and timely path that you might not need to go on.

Common Types of Imaging Used for Musculoskeletal Injuries 

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