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Dominic Cheetham

Upright vs Supine Imaging: When Weight-Bearing Imaging Can Improve Diagnosis

Posted on Tue Jul 7, 2026

Choosing the right imaging technique can make a significant difference when investigating patients with persistent spinal pain.

In this practical educational session from the Oryon Academy Spinal Symposium, speakers Dominic Cheetham and Dan Hughes explore how weight-bearing imaging can reveal biomechanical abnormalities that may not be visible on conventional supine MRI alone. The presentation compares upright X-ray, weight-bearing MRI and traditional supine imaging, highlighting situations where imaging patients under load may provide additional clinical insight.

The session discusses:

    • when upright imaging may identify pathology missed on supine MRI
    • leg length discrepancy and its effect on spinal biomechanics
    • functional scoliosis and postural assessment
    • spondylolisthesis and disc loading under weight-bearing conditions
    • when combining supine MRI with standing X-ray may improve clinical decision-making
    • practical considerations for referring patients with persistent low back pain.

    Rather than suggesting one imaging technique replaces another, the speakers explain how different modalities answer different clinical questions. Supine MRI continues to provide excellent soft tissue resolution, while upright imaging can demonstrate the effect of gravity and loading on the spine, helping clinicians better understand symptoms that occur during standing or movement.

    Watch the recording and claim your CPD

    The full recording is now available to watch on demand through Oryon Academy.

    After watching, simply complete the short feedback form to receive your CPD certificate.

    Watch now →

    Who should watch?

    This session is particularly relevant for:

    • Physiotherapists
    • Osteopaths
    • Chiropractors
    • Sports medicine clinicians
    • Extended Scope Practitioners
    • Orthopaedic clinicians
    • GPs with a musculoskeletal interest
    • First Contact Practitioners
    • Advanced Practice Physiotherapists

    About the Oryon Spinal Symposium

    This recording forms part of the Oryon Academy Spinal Symposium educational series, bringing together leading clinicians to share practical guidance on spinal assessment, imaging and patient management.

    Explore the full collection of on-demand talks to continue your CPD and discover practical insights from expert speakers.

    Explore the talks here →

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