How is articular cartilage damage diagnosed?

It can be difficult to diagnose an articular cartilage injury. Physical examination may show a swollen knee, but frequently the exam is normal.

Imaging may help the doctor make a diagnosis in some, but not all, cases. X-rays may be normal in most cases because only bone damage is visible on X-ray. One indication of advanced cartilage loss is a decrease in space between two bone surfaces. A loose bone fragment may be detected in a condition called osteochondritis dissecans (OCD), in which a portion of bone detaches with the articular cartilage.

An MRI (Magnetic Resonance Image) may reveal cartilage damage in many cases. The diagnosis may require the most sensitive and highest quality MRI images, which may also changes in the underlying bone. Cartilage thinning such as found in arthritis, may only be visible on MRI.

Sometimes, articular cartilage injuries may only be diagnosed with an arthroscopic examination of the joint. In this procedure, a tiny fiberoptic scope is inserted into the joint. The doctor uses this scope to visually assess the damage.

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