The first examination is plain films of the knee. The presence of severe degenerative change may answer the clinical question. MRI of the knee without contrast should be reserved for evaluation of ligamentous or meniscal injury or other pertinent orthopedic issues. When deciding whether or not to employ advanced imaging applications please consider whether or not the patient is a potential surgical candidate. If subsequent surgical intervention is not feasible there may be no need to proceed with further imaging evaluation. CT is primarily required for complex fracture evaluation; MRI may also be utilized for fractures.