Why X-ray Wasn’t Ordered Your Visit

Why X-ray Wasn’t Ordered Your Visit

Why X-Rays Are Not Always Ordered in the Office

Most patients coming in for an orthopedic appointment assume they will be getting an x-ray and are sometimes disappointed to find out the doctor does not order one. X-rays are not always needed.

First of all, if you have been to an urgent care clinic or to your Primary Care physician who has ordered an x-ray or MRI, please bring this with you to the scheduled appointment. If our physician does not have your films to review, it is difficult to render an opinion on them based solely on the report.  The physicians would like to review the images themselves.

X-rays are not always needed. It is best to follow conservative care within the first 2-3 weeks of an injury, with rest, ice and anti-inflammatories. Most soft tissue injuries will improve greatly by that time and unnecessary exposure to radiation from x-ray or CT scans can and should be avoided. Most people don’t realize that x-ray exposure is cumulative and can add up over the course of time.

Fracture care is a little different. If a fracture is suspected, an x-ray will be ordered at the time of the first visit if not already done.  X-rays will be repeated at follow up visits in order to confirm proper healing and alignment of the fracture. If malalignment or poor evidence of healing, additional therapies may be ordered to enhance the healing process.

It is understandable to see why some patients are impatient to have the x-ray and find out “what is wrong” with them, but hopefully this information will shed some light on why x-rays are often not ordered at the time of the first visit.


  • Keating JL, McKenzie JE, O'Connor DA, French S, Walker BF, Charity M, Page MJ, Green SE. Providing services for acute low-back pain: A survey of Australian physiotherapists. Man Ther. 2016 Apr;22:145-52. PubMed PMID: 26732898

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