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Identifying Arthritis in the Knee

by Jaydee Vykoukal, PT, DPT October 06, 2020 0 Comments

woman with knee pain

Of the 51 million people who suffer from arthritis, osteoarthritis is by far the most common type. Arthritis in the oknee can make everyday activities difficult and is one of the top reasons for disability in people over 60. Early management can be a game-changer for addressing knee pain and loss of function. Discuss your pain with your doctor, and read on to learn more about the causes and symptoms of osteoarthritis knee—and how to relieve the pain and get back to your life.

What is Knee Osteoarthritis?

Osteoarthritis is also called wear-and-tear arthritis or degenerative joint disease. Knees are one of the most commonly affected areas. Within the knee joint is articular cartilage, a slippery, fibrous connective tissue that acts as a cushion and keeps bones from rubbing against one another. When the cartilage wears away, it becomes thinner and causes inflammation.

Knee osteoarthritis may affect one or both sides of your knee joint. Since it is a degenerative disease, it is often a long slow process over many years of overuse or wear. Often, symptoms will suddenly be present in the later decades of life and gradually get worse over the course of a year or two.  When left neglected, it can cause severe changes in quality of life or knee function that may result in disability or deformity.

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is the second most common form of arthritis that people suffer from. This disease is significantly different from osteoarthritis. While they both affect the joints, RA is an auto-immune disease that affects the tissue quality of the joints. Essentially, the body mistakenly attacks its own tissues, resulting in pain, inflammation, and deformity of the affected joints if left untreated. RA is most easily differentiated from OA because it typically affects many joints on both sides of the body at once.

The Stages of Osteoarthritis of the Knee

Knowing the stages of knee osteoarthritis will help you understand and expect the condition’s progression, meaning you can keep it well-managed. Here are the four stages:

Stage 1: Minor Osteoarthritis Knee

Stage 1 is classified as minor wear. During this stage, you will not likely experience discomfort or feel any pain. While your joints seem normal at this stage, the cartilage is now slightly damaged. A person with stage 1 osteoarthritis knee might have small lumps of bone, also known as osteophytes, growing in the knee area due to uneven wear of the joint.

There would be little reason for this stage to be diagnosed unless imaging was done for an unrelated reason. Also remember that some wear and tear like this is normal with aging and is not necessarily a cause for concern.

Stage 2: Mild Osteoarthritis Knee

With stage 2 osteoarthritis knee, the cartilage might still be a healthy size, but there are already signs of wear and more bone spur growth. The tissues and contacting bone surfaces begin to be affected with stiffness and pain. A person with stage 2 osteoarthritis knee begins to experience mild to moderate symptoms.

Stage 3: Moderate Osteoarthritis Knee

At stage 3, the damage to the cartilage is obvious and worsening. The gap between the bones is now narrow, and doctors see clear cartilage loss with imaging. Those with moderate osteoarthritis knee experience joint inflammation and feel frequent discomfort during everyday life.

Stage 4: Severe Osteoarthritis Knee

Stage 4 is the most advanced phase of osteoarthritis knee. The gap between the bones is further lessened, and the signs of osteoarthritis are extremely visible. As the friction in the joint increases, so does the discomfort. Severe osteoarthritis knee means little to no cartilage is left and significantly affects knee function.

Causes of Arthritis of the Knee

Several studies have shown that women are at greater risk for developing osteoarthritis of the knee than men. But other key factors play huge roles in the development of the osteoarthritis knee:

  • Heredity

You are at a high risk if your siblings or parents have had osteoarthritis knee. Although more recent studies show this may have to do more with “inherited” lifestyle habits rather than the genes themselves.

  • Age

The risk of osteoarthritis of the knee increases after age 45. As you get older, some wear is normal, yet movement imbalances may exacerbate it and the body’s ability to heal itself gradually decreases.

  • Obesity

A person who is overweight or obese is more likely to suffer from osteoarthritis in the knee, as increasing weight puts more pressure on all joints.

  • Athletics

Osteoarthritis knee pain is more common in athletic elderly people who are involved in tennis, cycling, or long-distance running. Although, it greatly depends on the level of activity, overuse, and other injuries they have sustained over their lifetime.

  • Overuse

Excessive use of the knee joint—such as frequent squatting, kneeling, or heavy lifting with poor form—can cause osteoarthritis of the knee due to the constant pressure on cartilage.

  • Other Illnesses

Other types of joint diseases, such as gout or rheumatoid arthritis, increase the likelihood of developing knee osteoarthritis.

    Knee Arthritis Symptoms

    Identifying osteoarthritis knee symptoms is key to seeking medical advice and getting on the road to recovery to prevent unnecessary suffering. Signs of osteoarthritis in knee may include:

    • Stiffness in the knee
    • Feeling of weakness with normal daily activities
    • Swelling, but usually without any sensation of “warmth”
    • Difficulty walking, using the stairs, or getting in and out of cars
    • Loose fragments of cartilage and other tissue that affect the smooth movement of joints and cause the joint to feel “locked” 
    • A grinding, crunching, or creaking sensation when moving the knee joint

    How is Knee Arthritis Diagnosed?

    After identifying the symptoms of knee osteoarthritis and discussing personal and family medical history, your doctor will conduct a full physical examination, along with special diagnostic tests, such as those listed below.

    • Knee X-Ray Osteoarthritis

    Apart from revealing cartilage and bone damage, X-rays can detect the presence of bone spurs (osteophytes). An X-ray creates a detailed image of dense structures, such as bone. A knee X-ray may show alarming changes to the bone and unveil a narrowing of the joint area. An X-ray is typically only needed with severe cases, otherwise it is best to start conservatively with options like physical therapy or general exercise.

      • MRI Scans

      Sometimes, an MRI scan is necessary to examine the soft tissues of the knees and determine the severity of the osteoarthritis. A doctor will suggest an MRI scan to obtain osteoarthritis knee pictures if the X-ray does not provide a clear diagnosis.

        Relieve Osteoarthritis Knee Pain

        Knee osteoarthritis affects elderly people in different ways. Therefore, talk to your doctor about your specific situation, and follow the recovery plan. Always start with at-home treatment and then get in touch with a movement specialist like a physical therapist. The best thing you can do for an arthritic knee is to keep it moving, as long as you know how to do so in a balanced way.

        Concentrate on enjoying activities that do not exacerbate your osteoarthritis knee, follow your doctor’s treatment plan, and learn to manage your knee pain in a way that doesn’t interfere with your life.


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        Jaydee Vykoukal, PT, DPT
        Jaydee Vykoukal, PT, DPT

        JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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