MRI vs. X-ray: What is the difference and when are they needed?
DEFINITION
MRI (Magnetic Resonance Imaging) and X-ray are both medical imaging techniques used to visualize the internal structures of the body. However, they work differently and are used for different purposes.
X-rays use ionizing radiation to produce images, which can penetrate soft tissue and provide information about bone structure. They are best suited for detecting bone fractures, tumors, or other abnormalities of the skeleton.
MRI, on the other hand, uses a strong magnetic field and radio waves to produce detailed images of soft tissue and organs without the use of ionizing radiation. This makes MRI ideal for visualizing organs such as the brain, spinal cord, and muscles, as well as for detecting certain conditions, such as tumors, herniated discs, and injuries to ligaments and tendons. MRI can also identify boney abnormalities but would not be used if there were not other suspicion of soft tissue involvement.
WHEN DO YOU NEED IMAGING
X-RAY
The decision of whether to use an X-ray or physical therapy depends on the specific condition being evaluated and treated. Typically, if a fracture is suspected, the person cannot bear weight, or a diagnosis of osteopenia/osteoporosis or other pertinent comorbidities are involved, then x-ray is the first line of treatment. However, if these conditions are not met and boney abnormality is not suspected, physical therapy is a better treatment avenue and decreases unnecessary exposure to radiation.
MRI
Physical therapy is recommended as the first line of treatment for many musculoskeletal conditions, such as back pain, joint pain, and sprains and strains. Physical therapy can help to alleviate pain, improve mobility, and promote healing through the use of exercises, manual therapy, and other techniques.
An MRI may be needed when physical therapy alone is not providing sufficient relief, when the cause of the symptoms is unclear, or when a more detailed evaluation is required to diagnose a complex condition or monitor progress. For example, an MRI may be needed to diagnose a tear in a ligament or muscle, to evaluate the severity of an injury to the spinal cord, or to detect changes in the joint or bones.
IMAGING OR PT FIRST?
As mentioned above, unless there are clear indicators of pathology that need to be identified, the preference is to seek more conservative treatment such as physical therapy first. Physical therapists are highly trained in musculoskeletal differential diagnosis, meaning they are able to differentiate between back pain related to muscles or bones vs back pain related to a kidney disorder or reproductive complications. For this reason, seeking a physical therapist out for diagnosis and treatment will decrease your healthcare burden and more likely than not get you back in action faster than the traditional imaging and pain medication route.
If opting for the imaging path first you run the risk of a false positive. For example, an MRI may reveal a mild herniated disc in the spine that is not causing any pain or other symptoms. In these cases, the MRI findings may indicate the presence of a problem, but the individual may not be aware of it or experiencing any related symptoms. This can perpetuate the feeling of an “unhealthy” or “fragile'“ body which can slow progress and make the patient feel like might never fully heal.
It is important to note that an MRI or X-ray is only one tool that can be used to evaluate the health of the body, and the results of an MRI exam should be interpreted in the context of a patient's medical history, symptoms, and other tests and procedures.
Take Aways
To summarize: X-rays and MRI’s are effective tools to identify musculoskeletal conditions when used appropriately. For most, if not all, musculoskeletal conditions, physical therapy is the preferred first line of treatment and eliminates unnecessary radiation exposure, decreases your healthcare costs as well as decreases pain medication prescription. When in doubt, always speak to a medical professional (like us!) if you don’t know which method to choose.
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[All information on this blog is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.]
