Diagnostics of osteoarthritis

The first conversation with you will give us important information if you suffer from osteoarthritis of the knee joint.

Typically you complain about progressive knee pain, which is activity related. In addition, many patients experience pain and stiffness in the morning.

Clinical examination aims to correlate and accurately localise the patient`s problems. Pain should be provoked by pressure or movement of the knee (flexion-extension, rotation).Ideally pain can be localised to anatomical structures such as the meniscus or patella.

For a more in depth clinical examination a variety of clinical tests are available. For example these combine pressure and rotation to examine the integrity of the meniscus. When pain is noted by the patient during the tests, it is indicative for a meniscal lesion.

Stability testing of all ligaments should always be performed in comparison to the contralateral joint. Here specific tests exist to test the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) or collaterals.

Conventional radiographs (anterior-posterior and lateral) should be performed in a weight bearing position, as only then the joint gaps can be sufficiently analysed.

Additional radiographs such as patellofemoral skyline view, weight bearing radiographs in flexion (Rosenberg) and long leg radiographs are often necessary to decide which treatment should be chosen for the patient.

MRI is only necessary in exceptional cases. However, it can be helpful when associated meniscus or ligament tears or an osteonecrosis are suspected.

In few cases SPECT/CT, which is a combination of a 3D scintigraphy (SPECT) and a CT, might help to assess the bone quality and degree of mechanical overloading.