Skip to Main Content


Most musculoskeletal injuries occur as a result of either trauma or overuse. Following a thorough evaluation by a qualified health-care professional, most patients are usually required to have a basic radiographic (x-ray) examination of the injured area to assist in confirming the diagnosis. Many of these individuals, however, will require the use of an advanced imaging modality such as ultrasound, computed tomography (CT), and/or magnetic resonance imaging (MRI) to increase the accuracy in diagnosing the specific nature of the injury. The purpose of this chapter will be to provide a basic understanding of the four major imaging modalities used in diagnosing injuries: x-ray, ultrasound, CT, and MRI. It will also review pertinent terminology, common imaging applications, and important safety precautions.


Historical Overview


Using an x-ray tube to produce x-rays and a sheet of x-ray film or image receptor placed in a specially designed cassette to capture the energy of the x-ray beam image is the most commonly used method of taking a radiograph. Since its beginning in the late 1800s, diagnostic radiography, also known as x-ray, has seen several technologic advancements in the design of the x-ray tube, x-ray film, and cassette. Advancements made in image receptor technology have evolved from glass plates, which were used initially, to polyester-base material, which is used currently. Film emulsions have experienced considerable change since they were first introduced. Historically, the x-ray image was produced by the direct exposure of the x-ray beam to the x-ray film. Today, the x-ray image is produced when the x-ray beam interacts with special phosphor crystals within intensifying screens located inside the film cassette. When x-rays interact with the phosphor crystals, a light of a specific wavelength is produced and exposes the x-ray film. This method reduces the amount of radiation necessary to create an x-ray image.


The latest technology incorporates the use of computer technology in what may be referred to as computed radiography or digital radiography. Digital radiography introduces a moving away from the traditional film-screen (hard copy) method of taking an x-ray to producing a digital (soft copy) image that is presented on a high-quality monitor. Digital images, once recorded, can be manipulated just like CT images. The density and contrast scale of the images can be adjusted to demonstrate the anatomy such as bone or soft tissue. The images can be magnified to better visualize small structures. Another advantage of digitally formatted images is that they can be reviewed using high-quality monitors located throughout the hospital in such locations as the emergency room, operating rooms, and patient floors. Soft-copy images can also be sent to other health-care professionals in other health-care settings on a compact disc (CD). Finally, the storage of soft-copy images requires less space than the traditional hard-copy film jacket. The patient's images are stored and maintained on a picture archive and communication system (PACS) for an indefinite period of time.


Radiographic Views


Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.


Create a Free MyAccess Profile

* Required Fields

Note: If you have registered for a MyAccess profile on any of the Access sites, you can use the same MyAccess login credentials across all sites.

Passwords must be between 6 and 40 characters long (no whitespace), cannot contain characters #, &, and must contain:
  • at least one lowercase letter
  • at least one uppercase letter
  • at least one digit

Benefits of a MyAccess Profile:

  • Remote access to the site off-campus on any device
  • Notification of new content via custom alerts
  • Bookmark your favorite content such as chapters, figures, tables, videos, cases and more
  • Save and download images to PowerPoint
  • Self-Assessment quizzes saved for quick review
  • Custom Curriculum access for both instructors and learners

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.