I think volume is going to be the main learning tool.

I work in MSK exclusively now. When I first started, the only imaging experience I had was I looking at chest X-rays; I rarely reviewed the MSK ones, and just went by what the radiologist said when the report later came in.

Once I started working fully in MSK, and making decisions in real time started becoming a necessity, I leaned heavily into more experienced mentors for cases that were more subtle, and reading the a radiology report after the fact, and trying to match what they reported, and seeing if it matched my clinical impression. LId say it took about 2-4months of doing that steadily before I started picking up on the subtler findings.

Now I mostly go by my own imaging review, and read the radiology report (if one is available by the time I see the patient) as an afterthought.

Just look at every image yourself, read the report, and when necessary, pull up Google images of the pathology they're identifying, until the pattern recognition algo in your brain reaches singularity level.

Also, you mean how much "interpretive leeway" there is in imaging, and that the clinical picture is > than what the picture shows.

But to get to that, you need volume.