Question:I just came back from the orthopedic surgeon's office. X-rays taken show the start of osteoarthritis. All the X-rays were taken with me standing. Wouldn't it be better to see them while off my feet? I'm not always on my feet.
Answer:Weight-bearing X-rays are typical when evaluating the ankles for osteoarthritis (OA). Body weight and putting weight through the feet and ankles does affect the line up of the bones and stability of the joint.
In addition to the position of the ankle bones, the radiologist and the orthopedic surgeon will look at the X-rays to see the condition of the bones and joint. The amount of space between the bones called the joint space is measured and compared to normal. Narrowing of the joint space is common with osteoarthritis.
Bone spurs or other changes in the bone are also noted. For example, sclerosis, an abnormal hardening or increased density of the bone can also be seen on X-ray.
The physician uses the results of clinical tests performed on you in the office along with X-ray findings to make a diagnosis of osteoarthritis. OA can be further grouped on the basis of severity as stage 1, 2 or 3.
In stage 2 OA, there is a narrowing of the joint space, whereas in stage 3 the joint space is gone altogether. Patients with stage 3 OA can have much more pain because the joint is no longer protected by cartilage. You may be walking (or standing) with bone on bone. Standing or weight-bearing X-rays help show this.Masato Takao, MD, PhD, et al. Reconstruction of Lateral Ligament with Arthroscopic Drilling for Treatment of Early-Stage Osteoarthritis in Unstable Ankles. In The Journal of Arthroscopic and Related Surgery. October 2006. Vol. 22. No. 10. Pp. 119-1125.
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