Arthrosis signs on X-ray | Diagnosis of arthrosis

Arthrosis signs on X-ray

A more reliable indication of arthrosis is usually only provided by an X-ray of the affected joint. There are four classic signs that the x-ray should show: 1) Diagnosis of joint space narrowing: joints that are over or wrongly loaded wear unevenly due to the movements performed. The joint space narrows, this narrowing can be detected in the X-ray image by two bone edges standing close together.

2) Diagnosis subchondral sclerotherapy: if the worn joint continues to be incorrectly loaded, it attempts to replace the worn joint space in some form. This is to allow alternative stability of the joint. Just below the articular cartilage, a bone-like material called subchondral sclerotherapy spreads.

This process is accompanied by: 3) so-called pebble cysts, the third radiological recognition image of arthrosis. 4) So-called osteophytes, which can also be seen in some courses in the radiograph. These indicate an increased bone formation process.

The four signs mentioned above are typical and usually occur in severe cases of arthrosis. However, they can also be absent (e.g. in stage 1, see arthrosis stages). Only half of the patients with radiological signs of arthrosis complain of pain.

Conventional x-rays do not show the joint cartilage, joint capsule and joint effusions directly. Therefore, in some cases additional imaging procedures must be used. A magnetic resonance imaging (MRI) examination is also known as magnetic resonance imaging or magnetic resonance imaging.

It is often used for the early detection or exclusion of arthrosis. The advantage of an MRI examination over X-rays or computed tomography is that X-rays are not used in an MRI. The detailed representation of the painful joint in the MRI is obtained by means of electromagnetic measurement of the different water content in the various tissues.

For this reason, an MRI examination is particularly well suited to imaging joints with water-containing cartilage, synovial fluid and mucous membrane. For this reason, magnetic resonance imaging is superior to CT imaging or X-rays in the case of ligament injuries (e.g. cruciate ligament rupture) or injuries or changes to the articular cartilage. An MRI examination must not be performed if the affected person has a pacemaker, cochlear implant, drug pump or metal splinters in his or her body. An MRI cannot be carried out even in the first three months of pregnancy (), in the event of intolerance to the contrast medium, certain kidney diseases or allergies.


Computer tomography (abbreviated: CT) is a particularly good way of imaging the bony structures of a joint. Computed tomography is based on the varying absorption of X-rays in the tissue. The different absorption is recorded by a computer and then converted into very detailed sectional images.

A CT examination is mainly used when bone fractures (fractures) are suspected. In the context of osteoarthritis, a CT examination can provide important information about bony changes that are often not properly visible in the X-ray image. In addition, a CT examination can provide information about bone remodeling processes resulting from load distribution.

In principle, however, the CT examination plays a subordinate role in the diagnosis of arthrosis and is more likely to be used for specific questions about the bone (e.g. bone fractures, bone tumours). A CT examination is contraindicated in pregnancy. If contrast media containing iodine are used, it should also not be performed in the case of thyroid carcinoma or allergies to contrast media containing iodine.