X-ray of ankle osteoarthritis
Author:
Mikael Häggström [notes 1]
Planning
Weight-bearing radiography.
Evaluation
The Kellgren-Lawrence scale has been recommended,[1] but in practice it is generally acceptable to give the degree as mild/moderate or severe.
| Grade | Description |
|---|---|
| 0 | No radiographic features of osteoarthritis |
| 1 | Osteophyte formation and possible joint space narrowing. The normal distances between the bones in the ankle are as follows:[2]
|
| 2 | Definite osteophyte formation with possible joint space narrowing |
| 3 | Multiple osteophytes, definite joint space narrowing, sclerosis and possible bony deformity |
| 4 | Large osteophytes, marked joint space narrowing, severe sclerosis and definite bony deformity |
Evaluate separately for the lateral versus medial side of the joint.
Varus or valgus
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Varus or valgus deformity, if suspected, can be measured with the frontal tibiotalar surface angle (TTS), formed by the mid-longitudinal tibial axis (such as through a line bisecting the tibia at 8 and 13 cm above the tibial plafond) and the talar surface.[3] An angle of less than 84 degrees is regarded as talipes varus, and an angle of more than 94 degrees is regarded as talipes valgus.[4]
Report
- Severity grading:
- A subjective grading of osteoarthritis is generally warranted, such as mild, moderate or severe, which may correspond to grades 1/2, 3 and 4, respectively, of the Kellgren-Lawrence scale. In Swedish practice, such subjective grading is regarded as sufficient to report for osteoarthritis, since the management of the disease depends on symptoms[5] and any varus/valgus deformity[6] rather than the exact grading of imaging findings.
- The most severe feature(s) of the osteoarthritis, such as joint space narrowing.
- Any varus/valgus deformity, and if such, the degree thereof.
Example:
|
Osteoarthritis which is severe medially with marked joint space narrowing. Varus deformity with frontal tibiotalar surface angle of 72°. |
- See also: General notes on reporting
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
- ↑ Nicolas Holzer, Davide Salvo, Anne Karien Marijnissen, Aminudin Che Ahmad, Emanuele Sera, Pierre Hoffmeyer, Anne Lübbeke Wolff, Mathieu Assal (2017-09-14). "How to assess ankle osteoarthritis: comparison of the Kellgren and Lawrence scale with functional outcome and digital image analysis ". Orthopaedic Proceedings 94-B. Archived from the original. .
- ↑ Imai, Kan; Ikoma, Kazuya; Kido, Masamitsu; Maki, Masahiro; Fujiwara, Hiroyoshi; Arai, Yuji; Oda, Ryo; Tokunaga, Daisaku; et al. (2015). "Joint space width of the tibiotalar joint in the healthy foot ". Journal of Foot and Ankle Research 8 (1). doi:. ISSN 1757-1146.
- ↑ Nosewicz, Tomasz L.; Knupp, Markus; Bolliger, Lilianna; Hintermann, Beat (2012). "The reliability and validity of radiographic measurements for determining the three-dimensional position of the talus in varus and valgus osteoarthritic ankles ". Skeletal Radiology 41 (12): 1567–1573. doi:. ISSN 0364-2348.
- ↑ Chapter 5 - Radiological morphology of peritalar instability in varus and valgus tilted ankles, in: T.L. Nosewicz (2018-09-25). Acute and chronic aspects of hindfoot trauma . University of Amsterdam, Faculty of Medicine (AMC-UvA). ISBN 9789463750479.
- ↑ . Joint distraction for ankle osteoarthritis, Interventional procedures guidance. National Institute for Health and Care Excellence (NICE) (2015-12-16).
- ↑ Barg, Alexej; Pagenstert, Geert I.; Hügle, Thomas; Gloyer, Marcel; Wiewiorski, Martin; Henninger, Heath B.; Valderrabano, Victor (2013). "Ankle Osteoarthritis ". Foot and Ankle Clinics 18 (3): 411–426. doi:. ISSN 10837515.
