Radiographic systems to classify osteoarthritis vary by which

joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw ...

is being investigated. In

osteoarthritis Osteoarthritis (OA) is a type of degenerative joint disease that results from breakdown of joint cartilage and underlying bone which affects 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the ...

, the choice of treatment is based on pain and decreased function, but radiography can be useful before surgery in order to prepare for the procedure.

Vertebral column

There are many grading systems for degeneration of

intervertebral disc An intervertebral disc (or intervertebral fibrocartilage) lies between adjacent vertebrae in the vertebral column. Each disc forms a fibrocartilaginous joint (a symphysis), to allow slight movement of the vertebrae, to act as a ligament to hol ...

s and

facet joint The facet joints (or zygapophysial joints, zygapophyseal, apophyseal, or Z-joints) are a set of synovial, plane joints between the articular processes of two adjacent vertebrae. There are two facet joints in each spinal motion segment and e ...

s in the cervical and

lumbar vertebrae The lumbar vertebrae are, in human anatomy, the five vertebrae between the rib cage and the pelvis. They are the largest segments of the vertebral column and are characterized by the absence of the foramen transversarium within the transverse ...

, of which the following radiographic systems can be recommended in terms of interobserver reliability: *Kellgren grading of cervical disc degeneration *Kellgren grading of cervical facet joint degeneration *Lane grading of lumbar disc degeneration *Thompson grading of lumbar disc degeneration (by magnetic resonance imaging) *Pathria grading of lumbar facet joint degeneration (by

computed tomography A computed tomography scan (CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers ...

) *Weishaupt grading of lumbar facet joint degeneration (by MRI and computed tomography) The Thomson grading system is regarded to have more academic than clinical value.

Shoulder

The Samilson–Prieto classification is preferable for osteoarthritis of the

glenohumeral joint The shoulder joint (or glenohumeral joint from Greek ''glene'', eyeball, + -''oid'', 'form of', + Latin ''humerus'', shoulder) is structurally classified as a synovial ball-and-socket joint and functionally as a diarthrosis and multiaxial join ...

Hip

The most commonly used radiographic classification system for osteoarthritis of the

hip joint In vertebrate anatomy, hip (or "coxa"Latin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) in medical terminology) refers to either an anatomical region or a joint. The hip region is ...

is the Kellgren–Lawrence system (or KL system). It uses plain radiographs. Osteoarthritis of the

may also be graded by Tönnis classification. There is no consensus whether it is more or less reliable than the Kellgren-Lawrence system. Severe (Tönnis grade 3) osteoarthritis of the hip

Severe (Tönnis grade 3) osteoarthritis of the hip

Knee

For the grading of osteoarthritis in the knee, the International Knee Documentation Committee (IKDC) system is regarded to have the most favorable combination of interobserver precision and correlation to knee

arthroscopy Arthroscopy (also called arthroscopic or keyhole surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the j ...

findings. It was formed by a group of knee surgeons from Europe and America who met in 1987 to develop a standard form to measure results of knee ligament reconstructions. The Ahlbäck system has been found to have comparable interobserver precision and arthroscopy correlation to the IKDC system, but most of the span of the Ahlbäck system focused at various degrees of bone defect or loss, and it is therefore less useful in early osteoarthritis. Systems that have been found to have lower interobserver precision and/or arthroscopy correlation are those developed by Kellgren and Lawrence, Fairbank, Brandt, and Jäger and Wirth. For the

patellofemoral joint In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint i ...

, a classification by Merchant 1974 uses a 45° "skyline" view of the

patella The patella, also known as the kneecap, is a flat, rounded triangular bone which articulates with the femur (thigh bone) and covers and protects the anterior articular surface of the knee joint. The patella is found in many tetrapods, such as m ...

Other joints

*In the

temporomandibular joint In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral synovial articulation between the temporal bone of the skull above and the mandible below; it is from these bones that it ...

, ''subchondral sclerosis of the mandibular condyle'' has been described as an early change, ''condylar flattening'' as a feature of progressive osteoarthritis, and narrowing of the temporomandibular joint space as a late stage change. A joint space of between 1.5 and 4 mm is regarded as normal. X-ray of ankle osteoarthritis

*For the

ankle The ankle, or the talocrural region, or the jumping bone (informal) is the area where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular ...

, the Kellgren–Lawrence scale, as described for the hip, has been recommended. The distances between the bones in the ankle are normally as follows: :*Talus - medial malleolus: 1.70 ± 0.13 mm :*Talus - tibial plafond: 2.04 ± 0.29 mm :*Talus - lateral malleolus: 2.13 ± 0.20 mm

References

{{Reflist Musculoskeletal radiographic signs Arthritis Medical scoring system

Vertebral column

Shoulder

Hip

Knee

Other joints

See also

References