Radiographic classifications of osteoarthritis

Radiographic systems to classify osteoarthritis vary by which joint is being investigated. In osteoarthritis, 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.

There are many grading systems for degeneration of intervertebral discs and facet joints in the cervical and lumbar vertebrae, of which the following radiographic systems can be recommended in terms of interobserver reliability:

The Thomson grading system is regarded to have more academic than clinical value.

The Samilson-Prieto classification is preferable for osteoarthritis of the glenohumeral joint.

The most commonly used radiographic classification system for osteoarthritis of the hip joint is the Kellgren-Lawrence system (or K-L system). It uses plain radiographs.

Osteoarthritis of the hip joint may also be graded by Tönnis classification. There is no consensus whether it is more or less reliable than the Kellgren-Lawrence system.

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 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-Lawrence, Fairbank, Brandt, and Jäger-Wirth.

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