The Kellgren Lawrence grading system is radiological classification of knee osteoarthritis. It progresses from grade 0 to grade IV and and based on xrays.
Knee osteoarthritis is a very common problem prevalent in all sections of society. While most of the changes are related to age, weight is a modifiable factor.
Grading of knee osteoarthritis is needed to gauge the severity of the disease, communication with colleagues and planning for the treatment.
There are a number of grading systems devised for knee osteoarthritis, the Kellgren-Lawrence grading scheme is the most widely used and accepted standard for diagnosis of osteoarthritis of knee.
No radiographic features of osteoarthritis are present.
There is doubtful narrowing of joint space narrowing [ A normal joint therefore appears to have a space between the bones. Any decrease in space implies a reduction in cartilage cover.] and possible osteophytes[small bony projections that from around joint margins.They are responsible for limiting range of motion and can cause pain.]
There is presence of osteophytes and possible joint space narrowing on anteroposterior weight-bearing radiograph.
[weight bearing radiographs imply xrays taken while person stands on both the feet. A non weight bearing xray is taken when person is lying down and thus not bearing weight on knees]
Grade III Kellgren Lawrence is characterized by multiple osteophytes, de?nite joint space narrowing, sclerosis [seen as increased white areas in the bone at the joint margin] and possible bony deformity.
It is characterized by large osteophytes, marked joint space narrowing, severe sclerosis and de?nitely bony deformity.
Criticism of Kellgren Lawrence grading scheme
The Kellgren Lawrence grading scheme has been criticized for characterizing the progression of osteoarthritis of knee as a linear process
and combining osteophyte and joint space narrowing measurements because they could also develop independently of itself.
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