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Radiology in osteoarthritis

Authoring team

Characteristic changes of OA are:

  • joint space narrowing - focal cartilage loss
  • subchondral sclerosis - increased trabecular thickness
  • bone cysts
  • osteophytes about the joint margins - central, marginal, periosteal
  • osteochondral "loose" bodies - islands of chondral metaplasia that have ossified

In the initial stages of OA, the first three features are restricted to the load-bearing part of the osteoarthritic joint. In more advanced disease all five features are present on non-weight-bearing and weight-bearing parts of the joint.

X-rays are not recommended for routine use unless the diagnosis is in doubt.

Reference:

  1. Osteoarthritis in over 16s: diagnosis and management. NICE guideline (October 2022)

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