8/15/2023 0 Comments Subchondral sclerosis![]() ![]() Ornetti P, Brandt K, Hellio-Le Graverand MP. Radiological assessment of osteo-arthrosis. Osteoarthritis: a review of strengths and weaknesses of different imaging options. Erosive osteoarthritis: a current review of a clinical challenge. This process is experimental and the keywords may be updated as the learning algorithm improves.īanks SE. These keywords were added by machine and not by the authors. Primary OA increases significantly in prevalence after the age of 50 with the majority of individuals demonstrating some form of OA after the age of 70 years. Obesity is the only modifiable risk factor. OA is a complex interaction of advancing age, genetic predisposition, mechanical stress, obesity, as well as metabolic and biochemical factors all of which may affect the degree, extent, and progression of disease. Primary OA may be localized or generalized. It occurs in joints without local predisposing factors. Primary OA is an age-related disease with a genetic susceptibility in some individuals to earlier onset and more rapid progression. There are two main forms, primary and secondary. Fragmentation and fissuring of greater than 0.5 inchesĬlassifications based on symptoms include the Cincinnati Knee Rating System, Activities of Daily Living Scale and Sports Activity Scale of the Knee Outcome Survey, the Lysholm Scoring Scale and others.Osteoarthritis (OA), also termed degenerative joint disease, is the most common arthritis. Fragmentation and fissuring of less than 0.5 inches Arthroscopic classifications such as that by Outerbridge assess articular cartilage damage, and are often used specifically in arthroscopy reports. Large osteophytes, marked joint space narrowing, severe sclerosis and definite bony deformity. Multiple osteophytes, definite joint space narrowing, sclerosis and possible bony deformity. Definite osteophytes and possible joint space narrowing. Doubtful joint space narrowing and possible osteophyte lipping. Based on four features, joint space narrowing, osteophyte formation, subchondral sclerosis and subchondral cysts, the following grades are described: Kellgren and Lawrence developed a radiographic classification in the 1950s which is generally used today. Generally however there is consensus that patients who reach a certain level of objective radiological change are likely to have significant symptoms and significant impairment. Other factors may be involved when there is an unexplained presence of severe symptoms with only mild radiographic changes, including secondary gain. On the other hand, many people with early radiographic changes experience no symptoms, and some patients with marked radiographic changes are able to function well with reasonable mobility including participation in sports. As noted above, many patients experience knee pain without any radiographic changes. Knee osteoarthritis can be graded by symptom, or by radiological classification. Arthroscopy will confirm the presence of cartilage pathology and is usually required for accurate grading of knee OA. MRI may show more detail of any cartilage destruction, along with other abnormalities to menisci and subchondral bone. Osteophytes may frequently be observed in addition to bone cysts and bone sclerosis. Patellofemoral OA typically causes pain rising from a seat, on using stairs or walking up and down hill.ĭiagnosis is generally confirmed by imaging, usually X-ray examination which shows progressive narrowing of the joint space due to loss of the articular cartilage. Wear in only the medial compartment may lead to varus deformity while wear in the lateral compartment may lead to valgus deformity. Pathology may be restricted to only one of the three joint compartments, with pain typically restricted to that compartment. As the condition progresses, instability, joint deformity and restricted range of movement may all develop. Early morning stiffness rarely lasting more than thirty minutes may be present, and stiffness during rest may be noted. Pain may be accompanied by crepitus and swelling of the joint. As symptoms progress pain at rest may also be experienced. Knee OA typically presents as increasing pain on extensive activity, relieved by rest. Each may have different presentations and prognoses. Knee OA can include pathology on the femoral, tibial and patellar surfaces in either of the three joint compartments, lateral, medial and patella-femoral. This progresses through the full thickness of the cartilage until bone is exposed. The process starts with breakdown of the cartilage matrix followed by fibrillation and erosion of the cartilage surface. Diagnosis of knee osteoarthritis is made on the basis of clinical findings, confirmed by imaging studies and arthroscopy. ![]()
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