I agree that X-rays are useless the vast majority of the time. 

 You can of course pick up lytic lesions from metastasis or plasmacytoma, or other bone-based cancers. Sometimes flexion/extension films are helpful, since MRIs are almost always static and supine (until dynamic MRIs obtain more w...

I routinely obtain anterior, lateral, and oblique views to gauge the extent of spondylitis. Findings such as spondylolysis, disc space narrowing, and even unsuspected fracture can be identified. Recently, I diagnosed unsuspected concomitant DISH as well as a cause of cervicalgia. Second, insurance c...

Insurance companies require X-ray to start authorization for MRI.

One exception would be in trauma patients where there is the need to rule out fracture and instability.