If you’re experiencing unusual pain or stiffness in your knee joints, ask your doctor if osteoarthritis may be the cause. Your doctor may recommend an X-ray of your knee to find out.
X-rays are quick, painless, and may help your doctor see the physical symptoms of osteoarthritis in your knee joints. This allows your doctor to prescribe treatments or lifestyle changes that can decrease the constant pain and inflexibility that comes with osteoarthritis.
To get an X-ray of your knee, you’ll need to go to an X-ray imaging lab. There, a radiologist or an X-ray technician can take an X-ray and develop a detailed image of your bone structure for a better view of what might be affecting your joint area. You might also be able to have an X-ray done at your doctor’s office if it has X-ray equipment and a technician or radiologist on-site.
You don’t need to do much to prepare for an X-ray. Your radiologist may ask you to remove clothing covering your knees so that nothing blocks the X-rays from taking a fully detailed image.
If you’re wearing any metal objects, such as glasses or jewelry, your radiologist will likely ask you to remove them so that they don’t appear on the X-ray image. Inform them of any metal implants or other metal objects in your body so that they know how to interpret the object on the X-ray.
If you’re of childbearing age, you may be asked to take a pregnancy test. If you’re pregnant, your radiologist may not permit you to have an X-ray taken in order to keep the fetus safe. In this case, you might be able to have your knee examined with an ultrasound or other imaging technique.
Before the X-ray, the radiologist will take you to a small, private room. Others who may have come with you to the procedure may be asked to leave the room during the X-ray to protect them from radiation.
You’ll then be asked to stand, sit, or lie down in a position that allows the X-ray machine to capture the best possible image of your knee joint. You may feel slight discomfort depending on your position, but you’ll likely be given an object to lean or lie against, such as a pillow, to minimize your discomfort. You’ll also be given a lead apron to wear so that the rest of your body isn’t exposed to radiation from the X-rays.
Once you’re in position and have taken all the necessary precautions, you’ll be asked to stay still until the X-ray procedure is complete. You might be asked to hold your breath to make sure that you stay as still as possible. If you move during the X-ray, you may have to repeat the procedure more than once, as the X-ray image might be too blurry.
A simple joint X-ray shouldn’t take more than a few minutes, including any repeat procedures. If you were injected with a contrast medium, or dye, to improve visibility of certain areas in the image, the X-ray may take an hour or more.
X-ray procedures carry minimal risks of causing cancer or other radiation side effects. The level of radiation produced by an X-ray is low. Only young children may be noticeably sensitive to the radiation.
X-ray imaging results are usually available immediately after the procedure for you and your doctor to view. In some cases, your doctor may refer you to a specialist, such as a rheumatologist who specializes in arthritis, for further examination of your X-rays. This can take anywhere from a few days to a few weeks depending on your healthcare plan and the availability of the specialist.
To check for osteoarthritis in your knee, your doctor will examine the bones of your knee joint in the image for any damage. They’ll also check the areas around your knee joint’s cartilage for any joint space narrowing, or cartilage loss in your knee joint. Cartilage isn’t visible on an X-ray image, but joint space narrowing is the most obvious symptom of osteoarthritis and other joint conditions in which cartilage has eroded. The less cartilage that’s left on your bone, the more severe your case of osteoarthritis.
Your doctor will also check for other signs of osteoarthritis, including osteophytes — more commonly known as bone spurs. Bone spurs are growths of bone that stick out of the joint and can grind against each other, causing pain when you move your knee. Pieces of cartilage or bone can also break from the joint and get stuck in the joint area. This can make moving the joint even more painful.
Your doctor may ask to do a physical examination before or after looking at your X-rays in order to inspect your knee for any visible swelling, stiffness, or other signs of joint damage.
If your doctor doesn’t see any signs of cartilage loss or joint damage in your X-ray, your doctor may check the X-ray for signs of any similar conditions, such as tendinitis or rheumatoid arthritis. With tendinitis, pain medications and lifestyle changes may relieve your joint pain if the joint is simply being overused or is inflamed. In the case of rheumatoid arthritis, you might require further tests, such as a blood test or an MRI scan so that your doctor can look at your joint more closely and prescribe long-term medications and treatment to control this condition.
If your doctor believes that you have osteoarthritis, your doctor may also do a joint fluid analysis to verify that you have osteoarthritis. Both involve taking fluid or blood from your knee joint with a needle. This may cause minor discomfort.
Once a diagnosis of osteoarthritis is confirmed, your doctor may prescribe pain medications, including acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil), to keep the pain under control.
Your doctor may also refer you to a physical or occupational therapist to help improve your knee’s flexibility. Physical therapy can also help you change the way you walk on the joint in order to minimize pain and be as active as you want or need to be for both work and your personal life.