1000020398.jpg
Describe it
analyse_media
Reading File
Bilateral Knee X-ray - Radiological Report
Patient: Ranjeet Kaur, 64-year-old female
View: Weight-bearing (erect) AP (anteroposterior) bilateral knee radiograph
Date: 29/06/2026 | Reporting: Dr. Balbir Singh Virk, Virk Hospital, Karnal
Radiological Findings
Alignment
- Mild bilateral varus (bow-leg) deformity - the mechanical axis of both legs has shifted medially, which both causes and accelerates inner-compartment wear.
Joint Space Narrowing
- Right knee (R): Severe, near-complete loss of medial joint space - approaching bone-on-bone contact.
- Left knee (L): Complete loss of medial joint space - frank bone-on-bone contact present.
- Lateral compartments are relatively preserved with only mild narrowing.
Bone Changes
- Osteophytes: Large marginal bone spurs along the medial and lateral margins of femoral condyles and tibial plateaus in both knees.
- Subchondral sclerosis: Marked increased density (whitening) of bone immediately beneath the joint surface, especially at the medial tibial plateaus - a reaction to loss of protective cartilage.
- Subchondral cysts: Subtle lucent areas in the medial tibial plateaus, indicating fluid pressure intrusion into bare bone.
- Tibial spine sharpening: Peaking of the intercondylar eminences bilaterally - a classic chronic OA sign.
Soft Tissues
- No gross effusion clearly visible on this exposure, though chronic low-grade synovitis is clinically expected at this severity.
Diagnosis
Severe bilateral (predominantly medial compartment) osteoarthritis
Kellgren-Lawrence Grade IV - the most advanced radiographic grade
Clinical Significance
| Feature | Implication |
|---|---|
| Bone-on-bone medial contact | Source of severe chronic pain and functional limitation |
| Varus malalignment | Mechanical overload perpetuates cartilage destruction |
| Grade IV bilaterally | Conservative therapy (NSAIDs, injections, physio) offers only palliative relief |
Management consideration: At this degree of joint destruction with bilateral involvement in a 64-year-old, this is a classic indication for Total Knee Arthroplasty (TKA) evaluation. The decision to operate is based on symptom severity and functional disability, not radiograph alone.
Disclaimer: This is an AI-generated radiological description for educational/reference purposes. All clinical decisions must be made by the treating orthopaedic surgeon.
This is a shared conversation. Sign in to Orris to start your own chat.