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knee osteoarthritis X-ray AP lateral joint space narrowing osteophytes

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knee osteoarthritis radiographic grading Kellgren Lawrence classification features

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Radiology Report

Patient: G. Veeraiah | Age/Sex: 65Y Male | Study: Bilateral Knee X-ray — AP & Lateral views | Date: 01-Apr-26 Institution: Sri Raksha Hospitals, Khammam

Findings

Right Knee:
  • AP view: Moderate-to-severe medial compartment joint space narrowing. Prominent medial and lateral femoral condyle osteophytes. Tibial plateau osteophytes noted. Subchondral sclerosis of the medial tibial plateau and medial femoral condyle. No acute fracture.
  • Lateral view: Anterior and posterior femoral osteophytes clearly visible. Patellofemoral joint shows reduced joint space with osteophyte formation at the superior and inferior poles of the patella. Tibial spurs present.
Left Knee:
  • AP view: Moderate medial compartment joint space narrowing, slightly less severe than the right side. Medial compartment osteophytes present. Subchondral sclerosis of the medial compartment. No acute bony injury.
  • Lateral view: Femoral osteophytes (anterior and posterior). Patellofemoral degenerative changes with joint space reduction. Tibial spurs present.
Bilateral assessment:
  • Varus (bow-leg) alignment suggested by the medial-predominant joint space loss bilaterally
  • No evidence of periarticular soft tissue calcification, loose bodies, or acute fracture
  • Bone density appears adequate for age
Knee OA radiographic landmarks — AP view
Annotated AP knee showing OARSI-relevant landmarks: osteophytes, JSN, subchondral sclerosis, and subchondral cysts

Kellgren-Lawrence Grading (Bilateral)

SideCompartmentKL GradeFeatures
RightMedialGrade 3Definite JSN, multiple osteophytes, sclerosis
RightPatellofemoralGrade 2–3Osteophytes, moderate JSN
LeftMedialGrade 3Definite JSN, osteophytes, sclerosis
LeftPatellofemoralGrade 2Osteophytes, mild JSN
KL Grade 3 = Moderate OA: Definite joint space narrowing, multiple osteophytes, subchondral sclerosis, possible bony deformity.

Impression

Bilateral knee osteoarthritis, KL Grade 3 (moderate-to-severe), right ≥ left, with predominant medial compartment involvement and associated patellofemoral degeneration bilaterally.

Clinical Correlation & Recommendations

  • Correlate with clinical symptoms (pain, crepitus, range of motion restriction, functional limitation)
  • Weight-bearing (standing) long-leg AP views recommended if surgical planning (TKR) is being considered — to assess mechanical axis and degree of varus deformity
  • Conservative management options: physiotherapy, quadriceps strengthening, weight reduction, NSAIDs/analgesics, intra-articular hyaluronic acid or corticosteroid injection (with caution regarding OA progression risk with repeated corticosteroid use)
  • Surgical referral for Total Knee Replacement (TKR) should be considered given the patient's age, bilateral Grade 3 disease, and likely functional impairment
This report is generated for clinical assistance. Final radiological interpretation should be confirmed by a qualified radiologist.
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