Different types of scans

What Types of Scans Are Used in Musculoskeletal (MSK) Care

When an injury is experienced, symptoms such as pain, stiffness, tingling, or numbness can be felt, one of the first questions is often: “do I need a scan to find out what’s wrong?”

Scans can be helpful in certain conditions and situations, however, not always necessary — and sometimes they can even cause confusion or be misleading. Below, we’ll explain the main types of scans used in musculoskeletal (MSK) care, when they’re helpful, and some common misconceptions.

1. X-Ray

X-Rays are usually the first scan requested. They’re excellent for picking up fractures, dislocations, and changes in the bones such as arthritis. They’re quick (usually 10-20 minutes), cheaper and widely available, but don’t show muscles, ligaments, or discs. Think of X-Rays as a simple snapshot of your bones. Great for spotting breaks or big changes, but they can’t show the “soft tissues” such as muscles or cartilage.

2. MRI (Magnetic Resonance Imaging)

MRI scans can provide detailed images of soft tissues — discs, ligaments, tendons, cartilage. It’s the gold standard for suspected disc issues, meniscal tears, or labral injuries. MRI is like a super high-definition photo of the inside of your joints and spine. MRI scans can also be used to diagnose broken bones, especially stress fractures that may not show up on an X-Ray. It’s very detailed, however, here’s the catch: it often shows “wear and tear” that many people have even without pain or other symptoms. So results must be interpreted carefully.

3. CT (Computed Tomography)

CT scans give highly detailed images of bone structures. They’re often used for complex fractures or surgical planning but are less effective than MRI for soft tissues. Imagine a 3D X-Ray. A CT can show broken bones or other soft tissue injuries in better detail. However may not be the best for muscles or ligaments.

4. Ultrasound (Musculoskeletal Sonography)

Ultrasound is an excellent, dynamic tool for looking at superficial soft tissues like tendons, bursae, hernia’s and muscle tears. It’s also used to guide injections. Similar to pregnancy scans, an ultrasound can show your tendons and muscles moving in real time. It’s often painless, and ideal for tendon related problems like “tennis elbow” or rotator cuff issues.

5. DEXA (Bone Density Scan)

Used to measure bone mineral density and assess fracture risk in osteoporosis. Not typically for acute injury. A DEXA scan measures bone strength. It doesn’t look for injuries but helps check for conditions like osteoporosis.

Key Takeaways

Most MSK problems don’t need a scan straight away — physiotherapy assessment is often enough.

• Scans can sometimes show “abnormalities” that are just normal age-related changes.

• The right scan, at the right time, can provide valuable information, especially when red flags are present or surgery is being considered.

If you’re unsure whether you need a scan, talk to your Physiotherapist. They’ll guide you on whether imaging is necessary — or whether starting treatment is the best next step.