Let your symptoms and exam guide care.

Your symptoms tell more than one scan

A scan may show a tear or worn cartilage, the smooth covering at a bone's end. It can't rate the ache. Some shoulders and knees show wear without hurting. Your doctor won't rely on the scan alone.

The sore movement helps find the cause.

Show your doctor where the ache sits. Move the joint the way you normally do. Mention swelling, weakness, or motion you've lost. Those details will show whether the scan finding matters.

Repeated strain can make a joint sore

Tendons join muscles to bones. Repeated strain can leave them sore and stiff. You'll often notice the ache after more walking or lifting. It'll sometimes ease once you've moved for a while.

A fall often feels different.

Sharp soreness or fast swelling can start right away. You may suddenly lose strength. Don't keep using a leg that won't hold you. Protect the joint and arrange an exam.

Warning signs need quick care

Get prompt help if a joint looks bent. Fever with a hot joint can't wait. Neither can new numbness or a pale foot. Seek care if your leg won't hold you.

Milder soreness gives you more time.

Ease any movement that makes the ache jump. Keep other activity that feels safe. If soreness doesn't settle, an exam can guide care. Regenerative treatment means a clinic option prepared there from your blood. It won't be chosen from a scan alone.

Sources

1. This review of imaging in tendinopathy makes the central point that there is NO direct link between tendon structural disorganisation on ultrasound or MRI and clinical symptoms, so imaging findings can create a confusing clinical picture rather than clarify it. It also examines whether imaging predicts onset of pain or clinical outcome, and whether tendon structure has to improve for the patient to get better.

   Docking SI, et al. — Tendinopathy: Is Imaging Telling Us the Entire Story?. J Orthop Sports Phys Ther, 2015. DOI: 10.2519/jospt.2015.5880.

2. Fifty-one people aged 40-70 with NO shoulder symptoms in either shoulder had one shoulder scanned by ultrasound. Abnormalities were found in 96% of them: subacromial-subdeltoid bursal thickening in 78%, acromioclavicular osteoarthritis in 65%, supraspinatus tendinosis in 39%, subscapularis tendinosis in 25% and a partial-thickness bursal-side supraspinatus tear in 22%.

   Girish G, et al. — Ultrasound of the shoulder: asymptomatic findings in men.. AJR Am J Roentgenol, 2011. DOI: 10.2214/AJR.11.6971.

3. A meta-analysis of 63 studies covering 5,397 knees of asymptomatic, uninjured adults found cartilage defects in 24% overall and meniscal tears in 10%, rising sharply with age: cartilage defects in 11% of adults under 40 and 43% of those 40 and over; meniscal tears in 4% under 40 and 19% at 40 and over. Bone marrow lesions were present in 18% and osteophytes in 25%.

   Culvenor AG, et al. — Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis.. Br J Sports Med, 2019. DOI: 10.1136/bjsports-2018-099257.

4. Tendinopathy is described in the Nature Reviews Disease Primers review as a complex, multifaceted tendon pathology - disorganised collagen fibres, increased microvasculature and sensory nerve ingrowth, dysregulated matrix homeostasis, increased immune cells and inflammatory mediators, and enhanced cell apoptosis - most commonly affecting the rotator cuff, the medial and lateral elbow epicondyles, the patellar tendon, the gluteal tendons and the Achilles. The authors state plainly that management consists of exercise and loading programmes, therapeutic modalities and surgery, and that their effectiveness 'remains ambiguous'.

   Millar NL, et al. — Tendinopathy.. Nat Rev Dis Primers, 2021. DOI: 10.1038/s41572-020-00234-1.

5. Across 516 hamstring injuries in 23 European professional football teams, 58% were imaged. Lay-off time tracked radiological grade closely: 8, 17, 22 and 73 days for grades 0 to 3. But 70% of the injuries were grade 0 or 1 - meaning NO fibre disruption visible on MRI - and those grades accounted for 56% of all days lost. Reinjuries were 16% of injuries and every single one was in the biceps femoris.

   Ekstrand J, et al. — Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play.. Br J Sports Med, 2012. DOI: 10.1136/bjsports-2011-090155.