Osteoarthritis classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Osteoarthritis}} | {{Osteoarthritis}} | ||
{{CMG}}; {{AE}}Mohammadmain Rezazadehsaatlou [2] | {{CMG}}; {{AE}}[[User:DrMars|Mohammadmain Rezazadehsaatlou]] [2]. | ||
==Overview== | ==Overview== | ||
Since [[Osteoarthritis|OA]] can affect any joint in human body. there several different classification system based on the involved joint and its location. | |||
==Classification== | ==Classification== | ||
<div style="-webkit-user-select: none;"> | <div style="-webkit-user-select: none;"> | ||
'''Western Ontario and McMaster Universities Osteoarthritis Index (''WOMAC'')''' is used to evaluate the pain, stiffness, and physical function among patients with hip or/and | '''Western Ontario and McMaster Universities Osteoarthritis Index (''WOMAC'')''' is used to evaluate the pain, stiffness, and physical function among patients with hip or/and knee osteoarthritis (OA). It consists of 24 different items divided into 3 subtypes<ref name="pmid2027113">{{cite journal |vauthors=Menkes CJ |title=Radiographic criteria for classification of osteoarthritis |journal=J Rheumatol Suppl |volume=27 |issue= |pages=13–5 |date=February 1991 |pmid=2027113 |doi= |url=}}</ref><ref name="pmid25748615">{{cite journal |vauthors=Glyn-Jones S, Palmer AJ, Agricola R, Price AJ, Vincent TL, Weinans H, Carr AJ |title=Osteoarthritis |journal=Lancet |volume=386 |issue=9991 |pages=376–87 |date=July 2015 |pmid=25748615 |doi=10.1016/S0140-6736(14)60802-3 |url=}}</ref>: | ||
*Pain consisted of 5 items: | *Pain consisted of 5 items: | ||
*Stiffness consisted of 2 items: | -Staying in bed, sitting or lying, standing, walking, and using stairs. | ||
*Physical Function consisted of 17 items: | *Stiffness consisted of 2 items: | ||
-After waking up in morning and later in the day. | |||
*Physical Function consisted of 17 items: | |||
-Using stairs, sitting, rising from sitting, standing, bending, walking, getting in and/or getting out of a car, during shopping, heavy household duties, light household duties, putting on/taking off socks, lying in bed, rising from bed, getting in and/or getting out of bath, getting on/off toilet. | |||
Osteoarthritis is radiographically classified depending on degree of joint involvement. The Kellgren-Lawrence is a common method to classify the severity of OA in knee using five different grades. This classification was proposed by Kellgren et al. in 1957 and then it was accepted by WHO in 1961. | Osteoarthritis is radiographically classified depending on the degree of joint involvement. The Kellgren-Lawrence is a common method to classify the severity of OA in the knee using five different grades. This classification was proposed by Kellgren et al. in 1957 and then it was accepted by WHO in 1961<ref name="pmid7752134">{{cite journal |vauthors=Altman RD |title=The classification of osteoarthritis |journal=J Rheumatol Suppl |volume=43 |issue= |pages=42–3 |date=February 1995 |pmid=7752134 |doi= |url=}}</ref>. | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|+'''Classification for Subsets of Osteoarthritis''' | |+'''Classification for Subsets of Osteoarthritis''' | ||
| Line 27: | Line 32: | ||
| | | | ||
| | | | ||
|'''1: Hands: Heberden’s and Bouchard’s nodes (nodal), erosive | |'''1: Hands: Heberden’s and Bouchard’s nodes (nodal), erosive interphalangeal arthritis (nonnodal), carpometacarpal joint, scaphotrapezial''' | ||
| | | | ||
|- | |- | ||
| | | | ||
| | | | ||
|'''2. Feet: | |'''2. Feet: Hallux valgus, hallux rigidus, contracted toes (hammer/cockup toes), talonavicular''' | ||
| | | | ||
|- | |- | ||
| Line 88: | Line 93: | ||
|'''1. Localized''' | |'''1. Localized''' | ||
|'''a. Hip diseases: Legg-Calve-Perthes, congenital hip dislocation, slipped capital femoral epiphysis, shallow acetabulum''' | |'''a. Hip diseases: Legg-Calve-Perthes, congenital hip dislocation, slipped capital femoral epiphysis, shallow acetabulum''' | ||
'''b. Mechanical and local factors: obesity (7) | '''b. Mechanical and local factors: obesity (7), unequal lower extremity length, extreme valgus/varus deformity, hypermobility syndromes, scoliosis''' | ||
|- | |- | ||
| | | | ||
| Line 94: | Line 99: | ||
|'''2. Generalized''' | |'''2. Generalized''' | ||
|'''a. Bone dysplasias: epiphyseal dysplasia, spondyloapophyseal dysplasia''' | |'''a. Bone dysplasias: epiphyseal dysplasia, spondyloapophyseal dysplasia''' | ||
'''b. Metabolic diseases: | '''b. Metabolic diseases: hemochromatosis, ochronosis, Gaucher’s disease, hemoglobinopathy, Ehlers-Danlos''' | ||
|- | |- | ||
| | | | ||
|'''c. Calcium Deposition Disease''' | |'''c. Calcium Deposition Disease''' | ||
|'''1. Calcium pyrophosphate deposition disease''' | |'''1. Calcium pyrophosphate deposition disease''' | ||
'''2. Apatite | '''2. Apatite arthropathy''' | ||
'''3. Destructive arthropathy (shoulder, knee)''' | '''3. Destructive arthropathy (shoulder, knee)''' | ||
| Line 112: | Line 117: | ||
|'''E. Other Diseases''' | |'''E. Other Diseases''' | ||
|'''1. Endocrine diseases: diabetes mellitus, acromegaly, hypothyroidism, hyperparathyroidism''' | |'''1. Endocrine diseases: diabetes mellitus, acromegaly, hypothyroidism, hyperparathyroidism''' | ||
'''2. Neuropathic arthropathy (Charcot joints)''' | '''2. Neuropathic arthropathy (Charcot's joints)''' | ||
'''3. Miscellaneous: frostbite, Kashin-Beck disease, Caisson’s disease''' | '''3. Miscellaneous: frostbite, Kashin-Beck disease, Caisson’s disease''' | ||
| | | | ||
|} | |} | ||
=='''Knee'''== | =='''Knee'''== | ||
<ref name="pmid25031368">{{cite journal |vauthors=Wright RW |title=Osteoarthritis Classification Scales: Interobserver Reliability and Arthroscopic Correlation |journal=J Bone Joint Surg Am |volume=96 |issue=14 |pages=1145–1151 |date=July 2014 |pmid=25031368 |pmc=4083772 |doi=10.2106/JBJS.M.00929 |url=}}</ref><ref name="pmid29329325">{{cite journal |vauthors=Dell'Isola A, Steultjens M |title=Classification of patients with knee osteoarthritis in clinical phenotypes: Data from the osteoarthritis initiative |journal=PLoS ONE |volume=13 |issue=1 |pages=e0191045 |date=2018 |pmid=29329325 |pmc=5766143 |doi=10.1371/journal.pone.0191045 |url=}}</ref> <ref name="pmid28917712">{{cite journal |vauthors=Luyten FP, Bierma-Zeinstra S, Dell'Accio F, Kraus VB, Nakata K, Sekiya I, Arden NK, Lohmander LS |title=Toward classification criteria for early osteoarthritis of the knee |journal=Semin. Arthritis Rheum. |volume=47 |issue=4 |pages=457–463 |date=February 2018 |pmid=28917712 |doi=10.1016/j.semarthrit.2017.08.006 |url=}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+International Knee Documentation Committee (IKDC Questionnaire) | |+International Knee Documentation Committee (IKDC Questionnaire) | ||
| Line 147: | Line 154: | ||
|- | |- | ||
|III(severe) | |III(severe) | ||
|Bony surfaces in contact over less than one quarter of the joint surface | |Bony surfaces in contact over less than one-quarter of the joint surface | ||
|- | |- | ||
|IV (very severe) | |IV (very severe) | ||
| Line 172: | Line 179: | ||
|Bone defect and/or loss 5-10 mm | |Bone defect and/or loss 5-10 mm | ||
|} | |} | ||
=='''Hip'''== | =='''Hip'''== | ||
<ref name="pmid25826635">{{cite journal |vauthors=Falez F, Casella F, Papalia M |title=Current concepts, classification, and results in short stem hip arthroplasty |journal=Orthopedics |volume=38 |issue=3 Suppl |pages=S6–13 |date=March 2015 |pmid=25826635 |doi=10.3928/01477447-20150215-50 |url=}}</ref><ref name="pmid25139720">{{cite journal |vauthors=Lee S, Nardo L, Kumar D, Wyatt CR, Souza RB, Lynch J, McCulloch CE, Majumdar S, Lane NE, Link TM |title=Scoring hip osteoarthritis with MRI (SHOMRI): A whole joint osteoarthritis evaluation system |journal=J Magn Reson Imaging |volume=41 |issue=6 |pages=1549–57 |date=June 2015 |pmid=25139720 |pmc=4336224 |doi=10.1002/jmri.24722 |url=}}</ref><ref name="pmid2545217">{{cite journal |vauthors=Steinhoff H, Lieutenant K, Schlitter J |title=Residual motion of hemoglobin-bound spin labels as a probe for protein dynamics |journal=Z. Naturforsch., C, J. Biosci. |volume=44 |issue=3-4 |pages=280–8 |date=1989 |pmid=2545217 |doi= |url=}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+Kellgren-Lawrence system | |+Kellgren-Lawrence system | ||
| Line 202: | Line 211: | ||
|- | |- | ||
|I (Mild) | |I (Mild) | ||
|Increased sclerosis, slight narrowing of the joint space, | |Increased sclerosis, the slight narrowing of the joint space, slight loss of head sphericity or lipping at the joint margins | ||
|- | |- | ||
|II (Moderate) | |II (Moderate) | ||
| Line 210: | Line 219: | ||
|Large cysts, severe narrowing or obliteration of the joint space, severe deformity of the head | |Large cysts, severe narrowing or obliteration of the joint space, severe deformity of the head | ||
|} | |} | ||
=='''Shoulder'''== | =='''Shoulder'''== | ||
<ref name="pmid9922529">{{cite journal |vauthors=Walch G, Boulahia A, Boileau P, Kempf JF |title=Primary glenohumeral osteoarthritis: clinical and radiographic classification. The Aequalis Group |journal=Acta Orthop Belg |volume=64 Suppl 2 |issue= |pages=46–52 |date=1998 |pmid=9922529 |doi= |url=}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+Samilson-Prieto classification | |+Samilson-Prieto classification | ||
| Line 225: | Line 236: | ||
|Inferior humeral or glenoid exostosis, or both, more than 7 mm in height, with narrowing of the glenohumeral joint and sclerosis | |Inferior humeral or glenoid exostosis, or both, more than 7 mm in height, with narrowing of the glenohumeral joint and sclerosis | ||
|} | |} | ||
=='''Vertebral column'''== | =='''Vertebral column'''== | ||
<ref name="pmid15723251">{{cite journal |vauthors=Lakshmanan P, Jones A, Howes J, Lyons K |title=CT evaluation of the pattern of odontoid fractures in the elderly--relationship to upper cervical spine osteoarthritis |journal=Eur Spine J |volume=14 |issue=1 |pages=78–83 |date=February 2005 |pmid=15723251 |pmc=3476682 |doi=10.1007/s00586-004-0743-z |url=}}</ref><ref name="pmid11866149">{{cite journal |vauthors=Kanai H, Igarashi M, Yamamoto S |title=Vertebral body fracture of the lumbar spine in elderly women: more severe in osteoarthritis of the knee than in femoral neck fracture |journal=Orthopedics |volume=25 |issue=2 |pages=163–7 |date=February 2002 |pmid=11866149 |doi= |url=}}</ref><ref name="pmid26076655">{{cite journal |vauthors=Junker S, Krumbholz G, Frommer KW, Rehart S, Steinmeyer J, Rickert M, Schett G, Müller-Ladner U, Neumann E |title=Differentiation of osteophyte types in osteoarthritis - proposal of a histological classification |journal=Joint Bone Spine |volume=83 |issue=1 |pages=63–7 |date=January 2016 |pmid=26076655 |doi=10.1016/j.jbspin.2015.04.008 |url=}}</ref><ref name="pmid24120397">{{cite journal |vauthors=Rutges JP, Duit RA, Kummer JA, Bekkers JE, Oner FC, Castelein RM, Dhert WJ, Creemers LB |title=A validated new histological classification for intervertebral disc degeneration |journal=Osteoarthr. Cartil. |volume=21 |issue=12 |pages=2039–47 |date=December 2013 |pmid=24120397 |doi=10.1016/j.joca.2013.10.001 |url=}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+Kellgren grading of cervical disc degeneration | |+Kellgren grading of cervical disc degeneration | ||
| Line 359: | Line 372: | ||
|Narrowing of the facet joint space and/or large osteophytes and/or severe hypertrophy of the articular process and/or severe subarticular bone erosions and/or subchondral cysts | |Narrowing of the facet joint space and/or large osteophytes and/or severe hypertrophy of the articular process and/or severe subarticular bone erosions and/or subchondral cysts | ||
|} | |} | ||
=='''Temporomandibular joint'''== | =='''Temporomandibular joint'''== | ||
<ref name="pmid25744069">{{cite journal |vauthors=Wang XD, Zhang JN, Gan YH, Zhou YH |title=Current understanding of pathogenesis and treatment of TMJ osteoarthritis |journal=J. Dent. Res. |volume=94 |issue=5 |pages=666–73 |date=May 2015 |pmid=25744069 |doi=10.1177/0022034515574770 |url=}}</ref><ref name="pmid24864071">{{cite journal |vauthors=Su N, Liu Y, Yang X, Luo Z, Shi Z |title=Correlation between bony changes measured with cone beam computed tomography and clinical dysfunction index in patients with temporomandibular joint osteoarthritis |journal=J Craniomaxillofac Surg |volume=42 |issue=7 |pages=1402–7 |date=October 2014 |pmid=24864071 |doi=10.1016/j.jcms.2014.04.001 |url=}}</ref> | |||
{| class="wikitable" | {| class="wikitable" | ||
|+Radiographic features Changes are usually more evident on the condylar side of the TMJ joint | |+Radiographic features Changes are usually more evident on the condylar side of the TMJ joint | ||
| Line 372: | Line 388: | ||
|subchondral cysts | |subchondral cysts | ||
|} | |} | ||
=='''Ankle''' == | =='''Ankle''' == | ||
<ref name="pmid22261013">{{cite journal |vauthors=Nüesch C, Valderrabano V, Huber C, von Tscharner V, Pagenstert G |title=Gait patterns of asymmetric ankle osteoarthritis patients |journal=Clin Biomech (Bristol, Avon) |volume=27 |issue=6 |pages=613–8 |date=July 2012 |pmid=22261013 |doi=10.1016/j.clinbiomech.2011.12.016 |url=}}</ref><ref name="pmid26611896">{{cite journal |vauthors=Claessen FM, Meijer DT, van den Bekerom MP, Gevers Deynoot BD, Mallee WH, Doornberg JN, van Dijk CN |title=Reliability of classification for post-traumatic ankle osteoarthritis |journal=Knee Surg Sports Traumatol Arthrosc |volume=24 |issue=4 |pages=1332–7 |date=April 2016 |pmid=26611896 |pmc=4823329 |doi=10.1007/s00167-015-3871-6 |url=}}</ref><ref name="pmid24008208">{{cite journal |vauthors=Barg A, Pagenstert GI, Hügle T, Gloyer M, Wiewiorski M, Henninger HB, Valderrabano V |title=Ankle osteoarthritis: etiology, diagnostics, and classification |journal=Foot Ankle Clin |volume=18 |issue=3 |pages=411–26 |date=September 2013 |pmid=24008208 |doi=10.1016/j.fcl.2013.06.001 |url=}}</ref> | |||
{| class="wikitable sortable mw-collapsible mw-collapsed" | {| class="wikitable sortable mw-collapsible mw-collapsed" | ||
|+''' Takakura Classification''' | |+''' Takakura Classification''' | ||
| Line 452: | Line 470: | ||
|- | |- | ||
|III | |III | ||
|Ankle arthritis with hindfoot deformity, tibial malunion, midfoot | |Ankle arthritis with hindfoot deformity, tibial malunion, midfoot abducts or adducts, supinated midfoot, plantarflexed first ray, etc | ||
|- | |- | ||
|IV | |IV | ||
|Types 1–3 plus subtalar, calcaneocuboid, or talonavicular arthritis | |Types 1–3 plus subtalar, calcaneocuboid, or talonavicular arthritis | ||
|} | |} | ||
==References== | ==References== | ||
{{reflist|2}}{{WH}} {{WS}} | {{reflist|2}}{{WH}} {{WS}} | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
Latest revision as of 20:15, 16 June 2018
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Osteoarthritis Microchapters |
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Osteoarthritis classification On the Web |
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American Roentgen Ray Society Images of Osteoarthritis classification |
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Risk calculators and risk factors for Osteoarthritis classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou [2].
Overview
Since OA can affect any joint in human body. there several different classification system based on the involved joint and its location.
Classification
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is used to evaluate the pain, stiffness, and physical function among patients with hip or/and knee osteoarthritis (OA). It consists of 24 different items divided into 3 subtypes[1][2]:
- Pain consisted of 5 items:
-Staying in bed, sitting or lying, standing, walking, and using stairs.
- Stiffness consisted of 2 items:
-After waking up in morning and later in the day.
- Physical Function consisted of 17 items:
-Using stairs, sitting, rising from sitting, standing, bending, walking, getting in and/or getting out of a car, during shopping, heavy household duties, light household duties, putting on/taking off socks, lying in bed, rising from bed, getting in and/or getting out of bath, getting on/off toilet.
Osteoarthritis is radiographically classified depending on the degree of joint involvement. The Kellgren-Lawrence is a common method to classify the severity of OA in the knee using five different grades. This classification was proposed by Kellgren et al. in 1957 and then it was accepted by WHO in 1961[3].
| I: Idiopathic | |||
|---|---|---|---|
| A: Localized | |||
| 1: Hands: Heberden’s and Bouchard’s nodes (nodal), erosive interphalangeal arthritis (nonnodal), carpometacarpal joint, scaphotrapezial | |||
| 2. Feet: Hallux valgus, hallux rigidus, contracted toes (hammer/cockup toes), talonavicular | |||
| 3. Knee | a. Medial compartment
b. Lateral compartment c. Patellofemoral compartment (chondromalacia) | ||
| 4. Hip | a. Eccentric (superior)
b. Concentric (axial, medial) c. Diffuse (coxae senilis) | ||
| 5. Spine (particularly cervical and lumbar) | a. Apophyseal
b. Intervertebral (disc) c. Spondylosis (osteophytes) d. Ligamentous (hyperostosis [Forestier’s disease or DISH]) | ||
| 6. Other single sites: shoulder, temporomandibular, sacroiliac, ankle, wrist, acromioclavicular | |||
| B. Generalized: includes 3 or more areas listed above (Kellgren-Moore) | 1. Small (peripheral) and spine
2. Large (central) and spine 3. Mixed (peripheral and central) and spine |
||
| II. Secondary | |||
| A. Posttraumatic | |||
| B. Congenital or Developmental Diseases | 1. Localized | a. Hip diseases: Legg-Calve-Perthes, congenital hip dislocation, slipped capital femoral epiphysis, shallow acetabulum
b. Mechanical and local factors: obesity (7), unequal lower extremity length, extreme valgus/varus deformity, hypermobility syndromes, scoliosis | |
| 2. Generalized | a. Bone dysplasias: epiphyseal dysplasia, spondyloapophyseal dysplasia
b. Metabolic diseases: hemochromatosis, ochronosis, Gaucher’s disease, hemoglobinopathy, Ehlers-Danlos | ||
| c. Calcium Deposition Disease | 1. Calcium pyrophosphate deposition disease
2. Apatite arthropathy 3. Destructive arthropathy (shoulder, knee) |
||
| D. Other Bone and Joint Disorders: avascular necrosis, rheumatoid arthritis, gouty arthritis, septic arthritis, Paget’s disease, osteopetrosis, osteochondritis | |||
| E. Other Diseases | 1. Endocrine diseases: diabetes mellitus, acromegaly, hypothyroidism, hyperparathyroidism
2. Neuropathic arthropathy (Charcot's joints) 3. Miscellaneous: frostbite, Kashin-Beck disease, Caisson’s disease |
Knee
| Grade | Description |
|---|---|
| A | No joint space narrowing (JSN) |
| B | >4 mm joint space; small osteophytes, slight sclerosis, or femoral condyle flattening |
| C | 2-4 mm joint space |
| D | <2 mm joint space |
| Grade | Description |
|---|---|
| I (mild) | Patellofemoral joint space > 3mm |
| II (moderate) | Joint space < 3 mm but no bony contact |
| III(severe) | Bony surfaces in contact over less than one-quarter of the joint surface |
| IV (very severe) | Bony contact throughout the entire joint surface |
| Grade | Description |
|---|---|
| 0 | Normal |
| 1 | Joint space narrowing is <3 mm of the joint space or <50% of the other compartment (with or without subchondral sclerosis) |
| 2 | Obliteration of joint space |
| 3 | Bone defect/loss <5 mm |
| 4 | Bone defect and/or loss 5-10 mm |
Hip
| Grade | Description |
|---|---|
| 0 | No joint space narrowing (JSN) or reactive changes |
| I | Doubtful JSN, possible osteophytic lipping |
| II | Definite osteophytes, possible JSN |
| III | Moderate osteophytes, definite JSN, some sclerosis, possible bone-end deformity |
| IV | Large osteophytes, marked JSN, severe sclerosis, definite bone ends deformity |
| Grade | Description |
|---|---|
| 0 | No osteoarthritis signs |
| I (Mild) | Increased sclerosis, the slight narrowing of the joint space, slight loss of head sphericity or lipping at the joint margins |
| II (Moderate) | Small cysts, moderate narrowing of the joint space, moderate loss of head sphericity |
| III (Severe) | Large cysts, severe narrowing or obliteration of the joint space, severe deformity of the head |
Shoulder
| Grade | Description |
|---|---|
| I | Inferior humeral or glenoid exostosis, or both, measuring less than 3 mm in height. |
| II | Inferior humeral or glenoid exostosis, or both, between 3 and 7 mm in height, with slight glenohumeral joint irregularity. |
| III | Inferior humeral or glenoid exostosis, or both, more than 7 mm in height, with narrowing of the glenohumeral joint and sclerosis |
Vertebral column
| Grade | Description |
|---|---|
| I | Minimal anterior osteophytosis |
| II | Definite anterior osteophytosis with possible narrowing of the disc space and some sclerosis of vertebral plates |
| III | Moderate narrowing of the disc space with definite sclerosis of vertebral plates and osteophytosis |
| IV | Severe narrowing of the disc space with sclerosis of vertebral plates and multiple large osteophytes |
| Grade | Description |
|---|---|
| 1 | Doubtful osteophytes on margins of the articular facets of apophyseal joints |
| 2 | Definite osteophytes and subchondral sclerosis in apophyseal joints |
| 3 | Moderate osteophytes, subchondral sclerosis and some irregularity of articular facets |
| 4 | Many large osteophytes and severe sclerosis and irregularity of the apophyseal joints |
| Grade | Joint space narrowing | Osteophytes anterior and posterior | Sclerosis |
|---|---|---|---|
| 0 | None | None | None |
| I | Definite (mild) narrowing | Small | Present |
| II | Moderate | Moderate | – |
| III | Severe (complete loss of joint space) | Large | – |
| Grade | Nucleus | Anulus | Endplate | Vertebral body |
|---|---|---|---|---|
| I | Bulging gel | Discrete fibrous laminae | Hyaline, uniform thickness | Rounded margins |
| II | Peripheral white fibrous tissue | Mucinous material between laminae | Irregular thickness | Pointed margins |
| III | Consolidated fibrous tissue | Extensive mucinous infiltration; loss of annular-nuclear demarcation | Focal defects in cartilage | Small chondrophytes or osteophytes at margins |
| IV | Horizontal clefts parallel to endplate | Focal disruptions | Fibrocartilage extending from subchondral bone; irregularity and focal sclerosis in subchondral bone | Osteophytes smaller than 2 mm |
| V | Clefts extended through nucleus and annulus | Diffuse sclerosis | Osteophytes greater than 2 mm |
| Grade | Description |
|---|---|
| 0 | Normal |
| I | Joint space narrowing (mild degenerative disease) |
| II | Narrowing plus sclerosis or hypertrophy (moderate degenerative disease) |
| III | Severe osteoarthrosis with narrowing, sclerosis, and osteophytes (severe degenerative disease) |
| Grade | Description |
|---|---|
| 0 | Normal facet joint space (2–4 mm width) |
| I | Narrowing of the facet joint space (<2 mm) and/or small osteophytes and/or mild hypertrophy of the articular process |
| II | Narrowing of the facet joint space and/or moderate osteophytes and/or moderate hypertrophy of the articular process and/or mild subarticular bone erosions |
| III | Narrowing of the facet joint space and/or large osteophytes and/or severe hypertrophy of the articular process and/or severe subarticular bone erosions and/or subchondral cysts |
Temporomandibular joint
| flattening: common (in one series 27%) |
| osteophytes: common (27%) |
| erosions: 13% |
| sclerosis: less common (9%) |
| subchondral cysts |
Ankle
| Grade | Description |
| I | Early sclerosis and osteophyte formation, no joint space narrowing |
| II | Narrowing of medial joint space (no subchondral bone contact) |
| IIIA | Obliteration of joint space at the medial malleolus, with subchondral bone contact |
| IIIB | Obliteration of joint space over roof of talar dome, with subchondral bone contact |
| IV | Obliteration of joint space with complete bone contact |
| Grade | Description |
| 0 | Normal joint or subchondral sclerosis |
| I | Presence of osteophytes without joint-space narrowing |
| II | Joint-space narrowing with or without osteophytes |
| III | Subtotal or total disappearance or deformation of joint space |
| Grade | Description |
| 0 | No reduction of the joint space
Normal alignment |
| I | Slight reduction of the joint space
Slight formation of deposits at the joint margins Normal alignment |
| II | More pronounced change than mentioned above
Subchondral osseous sclerotic configuration Mild malalignment |
| III | Joint space reduced to about half the height of the uninjured side
Rather pronounced formation of deposits Obvious varus or valgus alignment |
| IV | Joint space has completely or practically disappeared |
| Grade | Description |
| I | Isolated ankle arthritis |
| II | Ankle arthritis with intra-articular varus or valgus deformity or a tight heel cord, or both |
| III | Ankle arthritis with hindfoot deformity, tibial malunion, midfoot abducts or adducts, supinated midfoot, plantarflexed first ray, etc |
| IV | Types 1–3 plus subtalar, calcaneocuboid, or talonavicular arthritis |
References
- ↑ Menkes CJ (February 1991). "Radiographic criteria for classification of osteoarthritis". J Rheumatol Suppl. 27: 13–5. PMID 2027113.
- ↑ Glyn-Jones S, Palmer AJ, Agricola R, Price AJ, Vincent TL, Weinans H, Carr AJ (July 2015). "Osteoarthritis". Lancet. 386 (9991): 376–87. doi:10.1016/S0140-6736(14)60802-3. PMID 25748615.
- ↑ Altman RD (February 1995). "The classification of osteoarthritis". J Rheumatol Suppl. 43: 42–3. PMID 7752134.
- ↑ Wright RW (July 2014). "Osteoarthritis Classification Scales: Interobserver Reliability and Arthroscopic Correlation". J Bone Joint Surg Am. 96 (14): 1145–1151. doi:10.2106/JBJS.M.00929. PMC 4083772. PMID 25031368.
- ↑ Dell'Isola A, Steultjens M (2018). "Classification of patients with knee osteoarthritis in clinical phenotypes: Data from the osteoarthritis initiative". PLoS ONE. 13 (1): e0191045. doi:10.1371/journal.pone.0191045. PMC 5766143. PMID 29329325.
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