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Osteoarthritis of the knee

Case contributed by: Dr Vivek Pai

Presentation:

Chief complaints of gradually progressive pain in both knees ,increasing on activity, and a valgus deformity

Patient Data:

Age: 75
Gender: Female
Race: Indian/Pakistani

Antero - Posterior View of both knees

Modality: X-ray

AP projection of both the knees reveals severe loss of joint space in both (medial > lateral) compartments associated with osteophytes , subchondral sclerosis and an obvious valgus deformity. The findings are suggestive of Grade 4 Osteoarthritis.

Case Discussion:

Radiography

Currently, the Kellgren-Lawrence (KL) grading scheme is the most- widely used and accepted standard for diagnosis of radiographic OA

  • Grade 0: No radiographic features of OA are present
  • Grade of 1: Doubtful joint space narrowing (JSN) and possible osteophytic lipping.
  • Grade of 2: The presence of definite osteophytes and possible JSN on anteroposterior weight-bearing radiograph.
  • Grade 3: Multiple osteophytes, definite JSN, sclerosis, possible bony deformity
  • Grade 4: Large osteophytes, marked JSN, severe sclerosis and definitely bony deformity

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