Which imaging modality is best for visualization of soft tissue structures such as tendons and bursae?

• A. MRI
• B. X-ray
• C. Ultrasound
• D. CT

Answer: (A)

Soft tissue detail is best captured by MRI because of its superior contrast between tendons, ligaments, muscles, bursae, and surrounding tissues, along with its multiplanar imaging capability. MRI uses sequences that highlight fluid and edema, such as fat-suppressed T2 or STIR, making pathologic fluid, inflammation, and tiny or deep tendon abnormalities conspicuous, including partial-thickness tears and bursitis. This level of detail in deep or complex joints goes beyond what X-ray or CT can provide, and while ultrasound is excellent for superficial tendons and dynamic assessment, it is more operator-dependent and limited for deep structures. Hence, MRI offers the most comprehensive visualization of soft tissue structures like tendons and bursae.