Suspected Stress Injury or Bone Pathology of the Elbow Not Seen on X-ray: When an MRI Scan Is Necessary

Frequently Asked Questions (FAQ)

What is a stress injury or occult bone pathology in the elbow?

A stress injury refers to bone damage caused by repetitive loading or overuse, rather than a single traumatic event. In the elbow, this may involve:

  • Bone marrow oedema (early stress reaction)
  • Stress fractures
  • Subtle bone injuries not visible on X-ray

These injuries are common in people who perform repetitive arm movements.

Who is at risk of elbow stress injuries?

Higher-risk groups include:

  • Athletes involved in throwing, racket sports, or weight training
  • Manual workers with repetitive lifting or gripping
  • Individuals who rapidly increase training intensity or workload

Symptoms often develop gradually rather than suddenly.

What symptoms suggest a possible stress injury in the elbow?

Symptoms may include:

  • Persistent deep elbow pain
  • Pain that worsens with activity and improves with rest
  • Localised tenderness over bone
  • Pain despite normal X-ray findings
  • Reduced tolerance to loading or repetitive movements

These symptoms are often misattributed to tendon or muscle strain.

Why are stress injuries often missed on X-ray?

X-rays may appear normal because:

  • Early stress injuries affect bone marrow before structural changes occur
  • Small fractures may not be visible initially
  • Overlapping elbow structures can obscure subtle findings

As a result, reliance on X-rays alone may delay diagnosis.

Why is MRI important when an elbow stress injury is suspected?

Core Medical Principles

  • MRI is one of the most accurate imaging modalities currently available.
  • Without accurate imaging, no doctor—regardless of experience—can reliably make a precise diagnosis.
  • Without accurate diagnosis, treatment plans become generic, presumptive, and often fail.
  • Many failed treatments are due to trial-and-error care without imaging.
  • Based on modern medical technology and current standard of care, MRI should be considered when an elbow stress injury or bone pathology is suspected despite normal X-rays.
  • MRI is safe and does NOT involve ionising radiation.

MRI can detect bone marrow oedema, early stress reactions, and subtle fractures.

Why are clinical examination and X-rays insufficient?

Clinical examination can localise pain but cannot:

  • Confirm bone marrow injury
  • Distinguish stress injury from tendon pathology
  • Assess severity of bone involvement

Advanced imaging is required for accurate diagnosis.

What happens if MRI is delayed?

Delaying MRI may result in:

  • Progression of bone injury
  • Prolonged pain and reduced function
  • Extended time away from work or sport

Early imaging often shortens recovery by guiding appropriate activity modification.

Is MRI expensive or difficult to arrange?

Addressing Patient Objections

  • Cost concerns: MRI costs may be partially offset by Medisave or insurance.
  • Delay elsewhere: External imaging centres often involve long waiting times.

Why arrange your elbow MRI at The Pain Relief Clinic?

Clinic Positioning

The Pain Relief Clinic is:

  • Centrally located at 350 Orchard Road, Shaw House
  • A 5-minute walk from Orchard MRT
  • Equipped with convenient parking
  • Located immediately outside ERP

Key advantages:

  • MRI machine on-site
  • Doctor can assess and arrange MRI immediately
  • No need to visit a separate imaging centre or seek another doctor for referral
  • The doctor has been helping patients with spine and joint-related problems since 2007 (18 years)
  • Focus on non-invasive, technology-powered treatments

MRI aims:

  • Under $1000
  • Within 1 working day

Can insurance or Medisave help cover elbow MRI costs?

Insurance & Cost Information

MRI may be covered by:

  • Personal accident insurance
  • Travel insurance
  • Company insurance
  • Company flexi-benefits
  • Hospitalisation plans (policy-dependent)

Medisave limits:

  • Current: $300
  • From 1 January 2026: $600

Medisave can potentially cover more than half of the MRI cost, depending on eligibility.

When should I consider an MRI for suspected elbow stress injury?

MRI should be considered if:

  • Elbow pain persists despite normal X-rays
  • Pain worsens with repeated use or loading
  • Symptoms limit work, sport, or daily activities

MRI helps move care from assumption-based treatment to precise, evidence-based diagnosis.

For more information or to arrange an MRI scan, contact The Pain Relief Clinic via WhatsApp at +65 9068 9605.

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