Diagnosing Osteoarthritis with a Knee Radiograph
One of the most common clinical entities seen by a sports medicine physician is knee pain. In our aging population, the incidence of osteoarthritis is increasing. Many of the cases of knee pain seen in the office are due to osteoarthritis. Sports physicians are typically charged with reading x-rays in office and must be aware of the signs of osteoarthritis of the knee on a radiograph.
A) Subchondral sclerosis
B) Pellegrini Stieda Sign
C) Symmetric joint space narrowing
Image 1. Medial joint space narrowing
Image 2. Subchondral sclerosis, severe joint space narrowing, osteophytes
Image 3. Osteophyte of the medial femoral condyle with joint space narrowin.
Figure 4. The kellgren-lawrence classification for knee osteoarthritis
Being able to recognize the signs of osteoarthritis on a radiograph is a necessary skill for a sports medicine physician. The incidence of knee OA is increasing in our population and diagnosing knee OA with a standard radiograph can be a cost saving measure. Being able to recognize joint space narrowing, subchondral sclerosis, and osteophyte formation will allow providers to make the correct diagnosis.
The correct answer is A. Subchondral sclerosis is found in radiographs with knee osteoarthritis. A Pelligrini Stieda sign is seen in injuries to the MCL. Symmetric joint space narrowing and erosions are found in Rheumatoid Arthritis.