Can an X-ray determine the severity of arthritis?

Grant Cooper, MD
Physical Medicine & Rehabilitation
The degree of severity of arthritis on an X-ray often does not correlate with symptoms. A person with a terrible looking X-ray of the knee may be completely symptom-free. Likewise, a person who shows minimal arthritis on an X-ray may be experiencing severe pain. This does not mean that one person is stoic and the other is a complainer. Different people have higher or lower thresholds for pain, depending on their body biochemistry and the synapses within their brain. Many factors influence the pain threshold in a given individual, including social support, depression, painful stimuli, and other potential biochemical and neuromodulating factors.

Someone who has severe cartilage degeneration may not have reached the point where the surrounding structures have become irritated and inflamed. If only cartilage is involved, there will be no pain because cartilage doesn't have any nerve endings. By contrast, the person with minimal X-ray findings of cartilage degeneration may just be unlucky enough to have the cartilage degrade in a pattern that allows pressure to be placed on the surrounding structures, leading to irritation and inflammation. Perhaps the synovium was already inflamed, or perhaps the bone was already compensating for increased pressure, and a tiny bone spur hooked a piece of the joint capsule or irritated a ligament.
The Arthritis Handbook: Improve Your Health and Manage the Pain of Osteoarthritis (A DiaMedica Guide to Optimum Wellness)

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The Arthritis Handbook: Improve Your Health and Manage the Pain of Osteoarthritis (A DiaMedica Guide to Optimum Wellness)

According to conventional wisdom, arthritis pain is an inevitable part of aging. Not so, says Dr. Grant Cooper in this practical, accessible guide. For those who do develop osteoarthritic conditions,...

Continue Learning about Arthritis Diagnosis

Arthritis Diagnosis

Arthritis Diagnosis

Doctors diagnose arthritis with a medical history and physical exam to check for joint inflammation and deformity. Your doctor may also order lab work like blood, urine and joint fluid tests. X-rays are commonly used to check for ...

cartilage loss in the affected joints, narrowing of the space between bones and the existence of nodules. Following the initial diagnosis, x-rays are also used to mark your arthritis progression.

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.