Xray Vrs. MRI: What is best?

For anyone not involved in the health care field, it can be very easy to become confused or even completely clueless to know the difference between getting an XRay or MRI. The only thing that most people seem to know is that an MRI usually costs more. With the way many insurance companies work, forcing their clients to get an XRay before allowing them to get and MRI, many individuals are led to believe the common misconception that they both are used to view the same thing. WRONG. XRay Imaging and MRI are two different processes used to visualize different structures, with very different details. In short here's what they SHOULD be used for:

X-Rays: Primarily used to view changes or abnormalities of bones. (Fractures, arthritis, tumors, dislocations, scoliosis, etc.) They can also be used to see some abnormalities in the lungs, heart, or areas where calcification might be take place such as the gall bladder or kidney. XRay do NOT visualize the Spinal Discs, only the spaces where the disc should be. Depending on the view, an X-Ray may be helpful to a practitioner in ruling out certain bony conditions, and give them clues as to weather or not a patients condition warrants further imaging of the soft tissues surrounding an area.

MRI: Used to view soft tissue structures such as the Spinal Disc, Meniscus, Ligaments and Tendons and muscle. Depending on the pathology suspected, a radiologist may inject certain fluids into an area to improve the contrast between structures that are being viewed.

There are several other methods used to visualize bony changes and soft tissue changes such as CT Scans and Bone Scans, but these are the most common. If a practitioner suggests sending you for Xraya or an MRI, make sure that you always ask them to explain why. I feel that it is an unfortunate state of many clinics (chiropractic, orthopedic, whatever) that Xrays are overused, often unneccessary, and often a misuse of healthcare dollars. If I suspect that a patient has a disc or soft tissue related problem such as a shoulder labrum or meniscal tear, and don't suspect damage to the bone, I'll often refer them out for an MRI. Why? This will be able to show me disruptions of both the soft tissue and bone, and eliminates the time and cost of getting an xray which probably wont show me anything anyhow. A patients history, orthopedic tests and physical examination can provide a great amount of information as to what a patients problem is, but with out the eyes of Superman, it is my opinion that an MRI is many times, (not all), the better way to go.