One of the most common questions I get in my clinic deals with whether or not a patient really needs an xray when he or she comes to the doctor to have an injury evaluated. Especially with recent insurance changes, patients are more conscious of costs than ever. Is it a good idea to skip xrays and go straight to an MRI for a knee injury, though?

Lori asks:
I was recently hurt, and I have no insurance and need to pay for my own care. My knee is swollen and painful. It’s difficult to bend and get in and out of the car. There is a crackling noise when I go up and down stairs. Since I need to pay without insurance, would it be more benificial to pay for an MRI or a X-ray? Will the MRI show the bone? I am not sure if this issue is bone or cartilage.

Xrays only show bones, while an MRI shows soft-tissue structures like muscles, tendons and ligaments. Many people – and some doctors – believe that a knee injury is automatically a ligament or meniscus tear, which wouldn’t show up on an xray. In this video, I explain why orthopedic surgeons generally don’t like to skip xrays before ordering an MRI.

Also read:
Ask Dr. Geier – Failure of meniscus repairs
Ask Dr. Geier – Arthritis after a meniscus tear

Xray showing knee arthritis

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