📌 Start simple: Plain X-ray or ultrasound first. MRI or CT follow only if deeper detail is needed.
Study | Typical insurer criteria | Why it matters | Notes & prep |
X-ray (2–3 views) | Trauma, swelling, pain > 1 wk, suspected fracture/arthritis | Finds breaks, dislocations, advanced arthritis. | No pre-auth; low dose. |
MSK ultrasound | Tendon, ligament, bursa pain; palpable mass | Dynamic view of rotator cuff, Achilles, effusions. | No radiation; office-based. |
MRI (no contrast) | Persistent pain, suspected meniscus/ACL tear, disc herniation | Gold standard for soft tissue & marrow. | 30 – 45 min; auth needed. |
MRI (with contrast) | Labral tear, osteomyelitis, tumor work-up | Highlights inflammation, tumors. | IV gadolinium; check kidneys. |
CT (no contrast) | Complex fracture planning, small bone detail | 3-D bony map; quick. | Higher dose; auth often. |
DEXA scan | Women 65 +, men 70 +, earlier if risk | Screens osteoporosis. | Very low dose. |
Typical sequence
X-ray for trauma/chronic pain.
Ultrasound ± injection for tendon/bursa issues.
MRI if pain persists > 4–6 wks or neuro signs.
CT for complex fractures/pre-op.
📌 Red-flags: sudden limb weakness, open fracture, feverish joint—seek urgent care.