Learn when MRI is essential—especially when X-rays are normal—and which hidden injuries require advanced imaging.

When MRI Truly Matters for Injury Detection

By MADI-BONE CLINIC — Gangnam (Seolleung Station)

“My X-ray Was Normal — So Why Do I Still Hurt?”

In orthopedic practice, this question appears daily.
X-rays often reveal fractures clearly,
yet many patients continue experiencing significant pain even when imaging looks normal.
This is when MRI becomes invaluable.

What X-ray Can—and Cannot—See

X-ray is excellent for:

fractures
joint alignment
bone degeneration

But it cannot visualize:

ligaments
tendons
cartilage
nerve irritation
bone marrow injury

This is why someone may be told:

“Your X-ray is fine — but the pain remains.”

When MRI Is Truly Needed

At MADI-BONE CLINIC, MRI is recommended when:

pain persists beyond 2–4 weeks
swelling or weakness does not improve
functional movements remain restricted
instability is suspected

MRI visualizes soft tissue architecture, marrow reaction and hidden injury patterns.

Hidden Injuries That MRI Detects

1. TFCC Tears

X-rays often miss triangular fibrocartilage complex (TFCC) damage.
MRI detects inflammatory reaction, tearing or degeneration.

2. Ligament Sprains and Partial Ruptures

Common in ankle, wrist, elbow and knee injuries — especially after falls.

3. Tendon Degeneration and Tear

Rotator cuff, Achilles and elbow tendons often look “normal” on X-ray but may show structural breakdown on MRI.

4. Cartilage and Meniscus Injury

Painful, yet invisible on standard radiographs.

5. Bone Marrow Edema — The Unknown Pain Generator

Bone bruising or marrow swelling causes intense pain despite normal radiographs.
MRI shows this clearly.

MRI is essential for detecting occult soft tissue and marrow injury.
MRI Detection Study

Why MRI Reveals So Much More Than X-ray

While X-ray visualizes skeleton structure,
MRI evaluates:

fluid and inflammation
tissue tearing
degeneration
nerve involvement

This makes it indispensable for persistent pain with unclear cause.

Common Scenarios Where MRI Changes Treatment

1. Someone Fell and “Sprained” Their Wrist

MRI may reveal TFCC injury or occult bone bruising.

2. Chronic Knee Pain With Normal X-ray

MRI often discovers meniscal tear or cartilage damage.

3. Resolving but Relapsing Ankle Pain

MRI identifies ligament instability or cartilage defect.

MRI Is Not Always Needed — But It Matters at the Right Time

Not every patient needs MRI immediately — but when symptoms persist or functional limitation exists,
MRI identifies conditions X-ray cannot.

Internal Links — Related Insights

Frequently Asked Questions (FAQ)

1. Should MRI be first-line testing?

Not usually — most musculoskeletal evaluation starts with X-ray because it excludes fractures and is cost-effective.
MRI is used when deeper structures require visualization.

2. Why did my pain start weeks after injury?

Soft-tissue or marrow-related injury can become more symptomatic once surrounding swelling resolves.

3. Is MRI necessary for every case?

No — but in persistent pain cases, MRI changes treatment decisions significantly.

MADI-BONE CLINIC — Seolleung Station

MADI-BONE CLINIC
3F, 428 Seolleung-ro, Gangnam-gu, Seoul
Seolleung Station Exit 1 — 3 minutes on foot
02-736-2626
⏰ Mon–Fri 09:30–18:30 / Sat 09:30–13:00