Knee XRay in Osteoarthritis

Aka: Knee XRay in Osteoarthritis, Osteoarthritis Knee XRay

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II. Indications

  1. Knee Trauma
  2. Significant joint effusion
  3. No prior knee disease diagnosis
    1. Loss of knee range of motion
    2. Pain not explained by ligament strain or Bursitis
    3. Severe or persistent Knee Pain
  4. Failed Osteoarthritis conservative therapy

III. Views

  1. Standing anteroposterior (weight bearing)
  2. Lateral
  3. Notch Patellar views (Sunrise view)
    1. Posteroanterior intracondylar (PAIC)
    2. Tangential Patellar

IV. Findings

  1. Joint space narrowing
    1. Medial tibiofemoral joint space narrowing
    2. Patellofemoral joint space narrowing
    3. Lateral joint space narrowing to lesser extent
  2. New subchondral bone formation
  3. Tibia lateral subluxation
  4. Osteophyte formation
    1. Medial osteophytes are most prominent initially

V. Grading: Kellgren-Lawrence Grading Systems for Knee Osteoarthritis

  1. Grade 0: No XRay Osteoarthritis findings
  2. Grade 1: Possible Osteoarthritis, but no significant joint space narrowing
  3. Grade 2: Definite Osteoarthritis with possible joint space narrowing
  4. Grade 3: Moderate osteophytes, definite joint space narrowing, subchondral sclerosis, possible bone end deformity
  5. Grade 4: Large osteophytes, marked joint space narrowing, severe sclerosis, definite bone end deformity
  6. Wing (2021) Skeletal Radiol 50(2):399-405 +PMID: 32780155 [PubMed]

VI. References

  1. Brower (1998) Arthritis Black and White, Saunders
  2. Klippel (1997) Primer Rheumatic Diseases, AF
  3. Boegard (1999) Skeletal Radiol 28:605-15 [PubMed]
  4. Peterson (1997) Ann Rheum Dis 56:493-6 [PubMed]
  5. Swagerty (2001) Am Fam Physician 64(2):279-86 [PubMed]

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