The past 50 years have transformed imaging of the joints. Whereas musculoskeletal imaging consisted predominantly of conventional radiography when Investigative Radiology was founded as a journal, the arrival of new imaging modalities, and above all, the introduction of magnetic resonance imaging, resulted in a paradigm shift: In addition to visualizing osseous structures, now the detailed depiction of soft tissue structures became part of routine clinical imaging and had a major impact on understanding pathophysiology and patient treatment. This article analyzes the patterns of innovation that were essential for the transformation of musculoskeletal radiology. Furthermore, state-of- the-art joint imaging is described through 9 key concepts, including both cutting-edge clinical applications as well as topics at the forefront of musculoskeletal research. Eventually, emerging trends are outlined that will likely shape musculoskeletal radiology in the next decades.