When you’re dealing with joint pain, sports injuries, or unexplained musculoskeletal symptoms, imaging often plays a central role in your diagnosis. Choosing the right type of scan, CT or MRI, can make a huge difference in accuracy and treatment decisions.

At MDView, we often help patients who were misdiagnosed or left confused by their initial imaging results. That’s because CT and MRI look at the body in fundamentally different ways, and not all radiologists specialize in musculoskeletal (MSK) imaging.

Here’s a breakdown of when each imaging method is best, and when they commonly miss the mark.

CT Scan: Best for Bone, Not Soft Tissue

CT (Computed Tomography) uses X-rays to create detailed images of bones and some surrounding tissues.

CT Is Best For:

• Complex fractures (e.g., pelvis, spine, facial bones)

• Joint dislocations

• Bone tumors

• Degenerative changes (like osteoarthritis)

• Surgical planning with hardware (metal implants don’t interfere as much with CT)

Common Misdiagnoses with CT for Musculoskeletal Issues:

• Soft tissue injuries missed: CT scans don’t show tendons, ligaments, or cartilage well, so injuries like ACL tears or rotator cuff tears are easily overlooked.

• Early stress fractures can be missed unless the bone reaction is well-developed.

• Subtle marrow abnormalities (like early infection or tumor) may go unnoticed.

MRI: The Gold Standard for Soft Tissue

MRI (Magnetic Resonance Imaging) uses magnets and radio waves, without patient exposure to radiation, to show soft tissues in great detail. It’s slower and more expensive than CT, but often far more informative.

MRI Is Best For:

• Ligament injuries (e.g., ACL, PCL, MCL in the knee)

• Tendon injuries (e.g., rotator cuff, Achilles)

• Meniscus or cartilage damage

• Muscle tears and strains

• Bone marrow abnormalities (e.g., infection, tumors, avascular necrosis)

• Spinal disc problems (herniations, nerve compression)

Common Misdiagnoses with MRI for Musculoskeletal Issues:

• Overcalling normal variants (like "tear" where there's just degeneration)

• Missing subtle fractures if the focus is too soft-tissue centered

• Wrong sequence choices by the imaging center can result in inadequate images for specific joints

• Non-specialized interpretation: General radiologists may miss or misread MSK-specific pathologies like labral tears, stress injuries, or subtle ligament disruptions.

Examples of Injuries and the Better Imaging Option

The Role of a Second Opinion in MSK Imaging

Even the right imaging won’t help if it’s interpreted by a radiologist unfamiliar with complex MSK injuries. We regularly see:

• Missed ligament tears leading to delayed surgery

• Overdiagnosed degenerative findings mistaken for acute injury

• Misinterpreted disc herniations in patients with chronic back pain

A second opinion from a fellowship-trained or specialized focused MSK radiologist, like the ones you can connect with on MDView, will provide clarity, correct a missed diagnosis, and prevent unnecessary procedures or delays.

When to Get a Second Opinion for Musculoskeletal Issues

• Your symptoms don’t match your imaging report.

• You’ve been told “everything looks normal” but you're still in pain.

• You’re considering surgery and want to confirm the diagnosis.

• Your report is vague or confusing.

Start your MSK Second Opinion Today with MDView

CT and MRI are both powerful tools in musculoskeletal imaging, but they each have limitations. Getting the right scan, and more importantly,  the right interpretation, can drastically change your treatment path. If you’ve had imaging done and are still uncertain about your diagnosis, consider a second opinion from a radiologist who specializes in your type of injury.

At MDView, we connect patients directly with expert MSK radiologists who deliver clear, actionable insights, often correcting missed or misunderstood findings.

Need clarity on your imaging?
Submit your MRI or CT scan to MDView for a fast, expert second opinion. Don't have your exam to upload? MDView can get it on your behalf at no cost to you, directly from the hospital or imaging center. Just click the Have MDView Get My Exam button to get started. 

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