How to Read an MRI Report: Common Musculoskeletal Terms Explained

An MRI report describes what a radiologist can see on the images, but it does not always identify the precise cause of pain. Start with the “Impression” or “Conclusion,” then review whether the reported findings correspond with your symptoms, injury history and examination. Terms such as “degenerative,” “mild” or “tear” should not be interpreted in isolation.

What Is an MRI Report?

An MRI report is a medical interpretation of magnetic resonance images prepared by a radiologist. It communicates the main imaging findings to the referring healthcare professional.

A report may describe:

• Bones and joints
• Discs and spinal structures
• Muscles and tendons
• Ligaments
• Cartilage
• Nerves
• Joint fluid
• Inflammation or swelling
• Previous surgical changes
• Unexpected or incidental abnormalities

Although MRI provides detailed anatomical information, the report is only one part of the diagnostic process. The radiologist may not have examined the patient or received every relevant detail about the symptoms.

The report should therefore be considered together with the patient’s history and physical examination.

The Main Sections of an MRI Report

The precise format varies between imaging providers, but most reports contain several standard sections.

Report section	What it usually contains
Examination	The body part and type of MRI performed
Clinical history or indication	The symptoms or clinical question supplied by the referring professional
Technique	How the images were obtained and whether contrast was used
Comparison	Previous scans used for comparison, if available
Findings	A detailed description of the structures visible on the MRI
Impression or conclusion	The radiologist’s summary of the most important findings

1. Examination

This identifies what was scanned.

Examples include:

• MRI lumbar spine
• MRI cervical spine
• MRI right knee
• MRI left shoulder
• MRI pelvis
• MRI ankle

Check that the correct body part and side are stated. A shoulder or knee report, for example, should identify whether the scan concerns the left or right side.

2. Clinical History or Indication

This section explains why the MRI was requested. Examples might include:

• Persistent lower-back pain
• Right-leg numbness
• Suspected meniscus injury
• Shoulder weakness after a fall
• Chronic ankle pain after a sprain

This information matters because it helps the radiologist focus on the clinical question.

A report may be less clinically specific if the indication only says “pain” without describing its location, duration, injury history or associated symptoms.

3. Technique

The technique section describes how the study was performed. It may mention:

• The imaging sequences used
• The anatomical planes obtained
• Whether contrast was administered
• Whether the examination was limited by movement
• Whether metal caused image artefact

Patients usually do not need to interpret individual MRI sequences. However, a technically limited examination may reduce how confidently certain structures can be assessed.

4. Comparison

The radiologist may compare the current MRI with:

• An earlier MRI
• An X-ray
• A CT scan
• Another relevant imaging study

Comparison can help establish whether an abnormality is:

• New
• Unchanged
• Improving
• Progressing
• Related to previous surgery or injury

If the report states “no prior imaging is available for comparison,” this does not make the MRI invalid. It means the radiologist cannot assess change over time.

5. Findings

The findings section describes the structures examined and any visible abnormalities.

It is often organised anatomically. A knee report, for example, might address the menisci, ligaments, cartilage, tendons, bones and joint fluid separately.

This section may contain technical language and several abnormalities of differing importance. Not everything listed necessarily requires treatment.

6. Impression or Conclusion

The impression—sometimes called the conclusion—is the radiologist’s summary of the most relevant findings.

This is usually the best place to begin reading because it identifies what the radiologist considers most important. However, it should not be treated as a complete diagnosis without clinical correlation.

A short impression may omit minor details contained in the findings section. Conversely, several findings may be summarised even though only one corresponds with the symptoms.

Common General Terms in MRI Reports

Unremarkable

“Unremarkable” generally means that no significant abnormality was identified in the structure being described.

It does not mean that the structure was ignored. It means its appearance did not require further comment.

Normal alignment

This means the bones or joints are positioned as expected on the images. In spinal reports, it may indicate that no significant vertebral displacement or abnormal curvature was identified in the scanned position.

Because MRI is usually performed while lying down, it may not reproduce symptoms or alignment changes that occur only during standing or movement.

Intact

“Intact” means that a structure does not show a visible tear or disruption.

For example:

• The anterior cruciate ligament is intact.
• The rotator cuff tendon is intact.
• The Achilles tendon is intact.

An intact structure may still show irritation, degeneration or surrounding inflammation.

No acute abnormality

This generally means no recent or urgent-looking structural abnormality was detected. It does not necessarily mean that the MRI is completely normal or that the patient has no explanation for pain.

Chronic

“Chronic” refers to a longstanding appearance rather than a recent injury. Radiologists may infer chronicity from features such as tissue remodelling, muscle atrophy or established degenerative change.

Incidental finding

An incidental finding is something identified unexpectedly that may be unrelated to the symptoms being investigated.

Some incidental findings require no action. Others may warrant monitoring or further assessment, depending on their nature.

What Does “Degenerative” Mean?

Degenerative changes are structural alterations that commonly develop through ageing, previous injury, repetitive loading and other factors.

The term does not necessarily mean that a joint or spine is rapidly deteriorating. It also does not prove that degeneration is causing the pain.

Examples include:

• Disc dehydration
• Reduced disc height
• Osteophytes
• Facet-joint arthritis
• Cartilage wear
• Degenerative meniscus tears
• Tendon degeneration

The importance of degeneration depends on its location, severity and relationship to the symptoms.

What Do Mild, Moderate and Severe Mean?

These terms describe the radiologist’s assessment of the imaging appearance.

They do not directly measure:

• Pain intensity
• Functional limitation
• Likelihood of recovery
• Need for surgery
• Response to treatment

A “mild” abnormality can sometimes be symptomatic, while a “severe” abnormality may cause limited discomfort.

The terms are also partly dependent on the structure being assessed and the grading system used. They should not be assumed to have identical meanings across all conditions.

Common Spine MRI Terms

Disc desiccation or dehydration

Spinal discs contain water. With age and degeneration, a disc may lose some water content and appear darker on MRI.

Disc desiccation is common and may or may not contribute to pain.

Loss of disc height

This means the space occupied by a spinal disc has become narrower. It commonly occurs with disc degeneration.

Its clinical importance depends on associated findings, such as nerve-space narrowing, instability or symptoms that correspond with the affected level.

Disc bulge

A disc bulge is a broad extension of disc tissue beyond its usual boundary.

Disc bulges are common, particularly with increasing age. A bulge is more likely to be clinically significant when it narrows a nerve space or corresponds with compatible symptoms and examination findings.

Disc protrusion

A protrusion is a more localised displacement of disc material. The base of the displaced material is wider than its outward extension.

A protrusion does not automatically require surgery.

Disc extrusion

An extrusion occurs when displaced disc material extends farther than the width of its connection to the main disc or travels above or below the disc level.

An extrusion may irritate or compress a nerve, but treatment still depends on symptoms, neurological findings and clinical progression.

Sequestered disc fragment

This means a piece of displaced disc material has separated from the main disc.

Its significance depends on its location, nerve involvement and the patient’s condition. Urgent surgery is not required solely because the word “sequestered” appears in a report.

Annular fissure

An annular fissure is a separation in fibres of the outer portion of a disc. It may occur with disc degeneration and can be found in people with or without symptoms.

The older term “annular tear” may also be used, but it does not necessarily indicate a recent traumatic tear.

Osteophyte

An osteophyte is a bony projection commonly associated with degeneration. It is often called a bone spur.

An osteophyte becomes clinically relevant when it restricts movement, affects a nerve or corresponds with symptoms.

Facet arthropathy

Facet joints connect the vertebrae at the back of the spine. Facet arthropathy means degenerative change in these joints.

Its presence does not by itself establish that the facet joint is the source of pain.

Spinal canal stenosis

Spinal canal stenosis means narrowing of the central passage containing the spinal cord or spinal nerves.

The importance depends on:

• The degree of narrowing
• Whether neural structures are compressed
• The spinal level
• Symptoms and examination findings

Foraminal stenosis

The neural foramina are openings through which spinal nerves leave the spine. Foraminal stenosis means one of these openings has narrowed.

It is more likely to be clinically relevant when the affected level and side correspond with pain, numbness or weakness.

Lateral recess stenosis

The lateral recess is part of the spinal canal through which a nerve root travels before exiting. Narrowing may affect the traversing nerve root.

Nerve-root contact, abutment or impingement

These terms describe different degrees of relationship between another structure and a nerve root.

• Contact or abutment: A structure touches the nerve.
• Impingement: The nerve appears affected or compressed.
• Compression: More definite pressure or deformation is present.

Wording varies among radiologists. Symptoms and neurological examination remain important.

Spondylosis

Spondylosis is a general term for degenerative changes in the spine, including disc and joint changes or osteophytes.

Spondylolisthesis

Spondylolisthesis means one vertebra has shifted relative to an adjacent vertebra. The direction and degree of displacement may be stated.

Its significance depends on stability, nerve involvement, symptoms and functional effect.

Cord compression

Cord compression means the spinal cord is being pressed by surrounding structures.

This requires clinical attention, particularly if there is limb weakness, loss of coordination, altered walking, hand clumsiness or bladder or bowel disturbance.

Myelopathy or myelomalacia

• Myelopathy describes dysfunction of the spinal cord.
• Myelomalacia refers to changes within the spinal cord associated with injury or longstanding compression.

If these terms appear in a report, timely medical review is appropriate.

Common Joint and Bone Terms

Joint-space narrowing

Joint-space narrowing is often an indirect sign of cartilage loss. It is usually assessed more directly on weight-bearing X-rays for some joints, although MRI can show the cartilage itself.

Chondral loss or chondropathy

“Chondral” refers to cartilage.

• Chondropathy means cartilage abnormality.
• Chondral thinning means reduced cartilage thickness.
• Full-thickness cartilage loss means cartilage is absent in a particular area.

The extent and location of cartilage loss should be considered alongside symptoms and function.

Osteoarthritis

MRI features of osteoarthritis may include:

• Cartilage loss
• Osteophytes
• Bone-marrow changes
• Joint-space changes
• Cysts
• Meniscus or labral degeneration
• Joint fluid

Imaging severity does not always correspond closely with pain severity.

Subchondral

“Subchondral” means beneath the cartilage surface of a joint.

Examples include:

• Subchondral oedema
• Subchondral cysts
• Subchondral sclerosis
• Subchondral fracture

These findings have different implications and should not be treated as interchangeable.

Bone-marrow oedema

Bone-marrow oedema describes increased fluid-sensitive signal within bone. It is an imaging pattern rather than a complete diagnosis.

Possible causes include:

• Injury or bone bruising
• Arthritis
• Stress reaction
• Fracture
• Infection
• Inflammation
• Reduced blood supply

The surrounding findings and clinical context determine its importance.

Bone bruise or contusion

A bone bruise is a microscopic bone injury that may occur after trauma. It can be painful even when an X-ray shows no fracture.

Fracture line

This indicates a break in the bone. The report may describe whether the fracture is acute, healing, displaced or associated with surrounding oedema.

Subchondral insufficiency fracture

This is a stress-related fracture beneath the joint surface, sometimes occurring without major trauma. It can require activity modification and medical management, so timely assessment is appropriate.

Cyst

A cyst is a fluid-containing or fluid-like structure. Examples include:

• Ganglion cyst
• Synovial cyst
• Baker’s cyst
• Subchondral cyst

The term “cyst” does not automatically imply cancer. Its significance depends on its type, location and appearance.

Lesion

“Lesion” is a general term for an area that differs from surrounding tissue. It does not by itself mean a tumour or cancer.

The report’s description of the lesion and any recommended follow-up are more informative than the word alone.

Common Tendon and Muscle Terms

Tendinopathy

Tendinopathy describes abnormal tendon structure, often related to repeated loading, ageing or previous injury.

It does not necessarily mean the tendon is inflamed. The older term “tendinitis” implies inflammation, while “tendinosis” generally refers to degenerative tendon change.

Partial-thickness tear

A partial-thickness tear affects part, but not all, of a tendon’s thickness.

Its importance depends on:

• The tendon involved
• Tear depth and size
• Injury history
• Weakness and function
• Symptoms
• Response to rehabilitation

Full-thickness tear

A full-thickness tear extends through the entire thickness of a tendon.

This does not necessarily mean the tendon is completely detached across its full width. Reports may separately describe the tear’s width, retraction and associated muscle changes.

Retraction

Retraction means the torn end of a tendon has pulled away from its normal attachment.

The amount of retraction may influence treatment options, particularly after an acute injury.

Muscle atrophy

Atrophy means loss of muscle volume. It can occur because of longstanding tendon injury, nerve problems, disuse or other conditions.

Fatty infiltration

Fatty infiltration means that some muscle tissue has been replaced by fat. In longstanding rotator cuff tears, for example, this may influence the feasibility and expected outcome of surgical repair.

Strain

A strain is an injury involving muscle or tendon fibres. MRI may grade the extent of injury, although grading systems vary.

Common Knee MRI Terms

Meniscus tear

The menisci are cartilage-like structures that distribute load within the knee.

Reports may describe tears as:

• Horizontal
• Vertical
• Radial
• Complex
• Longitudinal
• Bucket-handle
• Root tear
• Degenerative

The tear pattern, injury mechanism, symptoms and presence of arthritis all affect management.

Meniscal extrusion

Meniscal extrusion means part of the meniscus extends beyond the edge of the joint. It can occur with degeneration, meniscal root injury or osteoarthritis.

Meniscal root tear

A root tear affects the attachment that anchors the meniscus to bone. It can significantly alter how load is distributed across the knee and may warrant orthopaedic assessment in suitable patients.

ACL or PCL tear

The anterior and posterior cruciate ligaments help stabilise the knee. A report may describe a tear as partial, complete, acute or chronic.

Treatment depends on instability, activity goals, associated injuries and individual circumstances.

Chondromalacia

Chondromalacia describes cartilage softening or damage, commonly behind the kneecap. The term does not by itself identify the cause of anterior knee pain.

Common Shoulder MRI Terms

Rotator cuff tendinopathy

This describes structural change within one or more rotator cuff tendons. Its presence must be correlated with shoulder movement, strength and pain patterns.

Impingement

“Impingement” has historically described painful compression of shoulder tissues during movement. Imaging may show features associated with reduced space, but shoulder pain is not determined by the shape of one structure alone.

Subacromial-subdeltoid bursitis

This means increased fluid or inflammation within a bursa above the rotator cuff. It may be associated with tendon problems, injury or shoulder overload.

Labral tear

The labrum is a rim of tissue around the shoulder socket. Labral abnormalities can be traumatic, degenerative or incidental.

SLAP tear

A SLAP tear involves the upper portion of the shoulder labrum near the attachment of the biceps tendon. Its significance varies with age, injury mechanism and symptoms.

Adhesive capsulitis

Adhesive capsulitis, commonly called frozen shoulder, is primarily diagnosed from the clinical pattern of pain and restricted movement. MRI findings may support the diagnosis or help exclude other causes.

Other Frequently Used Terms

Effusion

An effusion is excess fluid within a joint.

It indicates that the joint is reacting to something but does not identify the cause. Causes can include injury, arthritis, inflammation or infection.

Synovitis

Synovitis means inflammation of the tissue lining a joint.

Bursitis

Bursitis is inflammation or irritation of a bursa, a fluid-containing structure that reduces friction between tissues.

Oedema

Oedema means increased fluid within tissue. It may occur with injury, inflammation, infection or other processes.

Scar tissue or fibrosis

Fibrosis refers to thickened connective or scar-like tissue. It may develop after injury, inflammation or surgery.

Artefact

An artefact is image distortion that does not represent actual anatomy.

Common causes include:

• Patient movement
• Metal implants
• Technical limitations
• Normal flow of blood or fluid

An artefact can sometimes make part of an examination difficult to interpret.

How to Interpret a Report More Safely

A practical approach is to ask five questions:

1. What was the clinical question?
   Was the scan investigating nerve compression, a tendon tear, arthritis or another specific concern?
2. What does the impression identify as most important?
   Do not give equal weight to every technical term in the findings section.
3. Does the location match the symptoms?
   Check the correct side, spinal level, joint compartment or tendon.
4. Does the examination support the finding?
   Imaging is more persuasive when it corresponds with weakness, restricted movement, sensation changes or relevant clinical tests.
5. Would this finding change treatment?
   Some abnormalities require action; others can be observed or managed conservatively.

Wording That May Require Timely Medical Review

Seek timely medical advice if a report mentions findings such as:

• Spinal cord compression
• Myelopathy or myelomalacia
• Cauda equina compression
• Acute fracture
• Infection or possible infection
• Suspicious bone or soft-tissue lesion
• Significant traumatic tendon rupture
• Subchondral insufficiency fracture
• Osteonecrosis
• Unexpected mass
• A recommendation for urgent clinical correlation

The appropriate urgency depends on the actual finding and symptoms. A report should not be interpreted without the referring clinician when potentially significant abnormalities are present.

Questions to Ask When Reviewing an MRI Report

Consider asking your healthcare professional:

• Which finding is most likely to explain my symptoms?
• Which findings may be age-related or incidental?
• Does the abnormality match the side and location of my symptoms?
• Are any nerves, the spinal cord or other important structures affected?
• Does this result change the diagnosis?
• Does it change what treatment is recommended?
• Is follow-up imaging necessary?
• Are there symptoms that should prompt earlier review?
• Is another test or specialist opinion appropriate?
• Could treatment begin without further imaging?

Frequently Asked Questions

Should I read only the impression?

Start with the impression, but do not ignore the rest of the report. The findings section provides detail and may describe minor or uncertain abnormalities not included in the summary. The report should ultimately be reviewed in clinical context.

Does “degenerative” mean my condition will keep getting worse?

Not necessarily. It usually describes structural changes associated with ageing, previous injury or accumulated loading. Symptoms may improve even when the imaging appearance remains unchanged.

Does “tear” mean I need surgery?

No. The need for surgery depends on the structure involved, type of tear, injury mechanism, symptoms, weakness, functional limitation and response to non-surgical care.

Does “no nerve compression” mean my symptoms cannot be nerve-related?

Not always. MRI is performed in a static position, and symptoms can be intermittent or caused by factors not clearly visible on imaging. The diagnosis should incorporate neurological symptoms and examination findings.

What does “clinical correlation recommended” mean?

It means the imaging appearance should be compared with the patient’s symptoms, history and physical examination before a conclusion is reached.

Why does the report list several abnormalities?

MRI is sensitive and may identify multiple age-related, previous or incidental changes. The task is to determine which, if any, are clinically important.

Is the longest section of the report the most serious?

No. The amount of description does not necessarily indicate severity. Some important findings can be stated in one sentence, while complex but non-urgent degeneration may require several paragraphs.

Should I repeat an MRI if I do not understand the report?

Usually not for that reason alone. A medical review of the existing report and images is generally more appropriate. Repeat imaging may be considered if the original examination was inadequate, symptoms have materially changed or a new clinical question has arisen.

Medical Assessment

If an MRI report is difficult to reconcile with your symptoms, a medical assessment can help determine which findings are clinically relevant and whether treatment, observation, further testing or referral should be considered.

The Pain Relief Clinic provides assessment by a licensed medical doctor, access to in-house physiotherapy and diagnostic imaging pathways where medically appropriate. Referral for specialist or surgical review may be considered when indicated.

For appointments or enquiries, call or WhatsApp +65 9068 9605.

References

1. Radiological Society of North America and American College of Radiology. How to Read Your Radiology Report. RadiologyInfo.org
2. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR American Journal of Neuroradiology. 2015;36(4):811–816. PubMed
3. Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0. The Spine Journal. 2014;14(11):2525–2545. PubMed
4. Englund M, Guermazi A, Gale D, et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. New England Journal of Medicine. 2008;359:1108–1115. PubMed
5. American College of Radiology. ACR Appropriateness Criteria. American College of Radiology
6. National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. NICE Guideline NG59. NICE

Medical Disclaimer

This article is for general educational information and does not replace an individual medical assessment. MRI terminology must be interpreted in relation to symptoms, examination findings, medical history and individual circumstances. Seek prompt medical attention for progressive weakness, bladder or bowel changes, saddle numbness, loss of coordination, severe trauma, fever with severe pain or other concerning symptoms.

Reviewed by Dr Terence Tan, Founder of The Pain Relief Clinic — 19 September 2026