Millions of people around the world live with ongoing knee pain, and one of the most common causes is osteoarthritis. In Australia alone, more than two million people are affected by this condition.
It is one of the leading causes of pain, reduced mobility, and disability, especially among older adults. Many people believe that an x-ray is needed before a doctor can tell whether they have osteoarthritis, but medical experts say that is often not the case.
Osteoarthritis is a condition that develops when joints try to repair themselves after years of stress, injury, or repeated use. It is often described as a disease of aging, but it can affect people of different ages. Previous knee injuries, excess body weight, and long-term strain on the joints can increase the risk.
The condition does not only affect bones. It can also involve cartilage, muscles, ligaments, and other tissues around the joint. As a result, people may experience pain, swelling, stiffness, and difficulty carrying out everyday activities such as walking, climbing stairs, or standing for long periods.
Many people are surprised to learn that doctors can often diagnose knee osteoarthritis without using any scans. A diagnosis can usually be made by discussing symptoms, medical history, and age.
For example, if a person is over 45 years old, experiences knee pain during activity, and does not have long periods of morning stiffness, these signs may be enough for a doctor to identify the condition.
Even though clinical guidelines suggest that scans are often unnecessary, many patients with knee pain are still sent for x-rays. These tests cost the Australian healthcare system more than $100 million each year. In many cases, the information from the scan does not change the treatment plan.
One reason doctors are becoming more cautious about routine x-rays is that scan results do not always match a person’s symptoms. Some people experience severe knee pain even when an x-ray shows only minor changes.
Others have significant changes visible on a scan but feel little or no pain. This means an x-ray image cannot fully explain how a person feels or how much the condition affects daily life.
The good news is that surgery is not the only option for managing osteoarthritis. In fact, most people can benefit from non-surgical approaches. Regular physical activity, strength exercises, learning about the condition, weight management when appropriate, and pain-relieving medicines such as paracetamol or anti-inflammatory drugs can all help improve symptoms.
Knee replacement surgery may be useful for some people with severe pain and major limitations, but it is usually considered only after other treatments have been tried. Surgery also carries risks, including infection, blood clots, and long recovery periods.
Researchers recently explored whether seeing x-ray images could influence how people think about knee osteoarthritis. The study was published in the journal Osteoarthritis and Cartilage. The research team recruited 617 adults in Australia and showed them videos of a doctor explaining a diagnosis of knee osteoarthritis.
Participants were divided into three groups. One group received an explanation without any mention of an x-ray. A second group was told about x-ray findings but did not see an image.
A third group was shown the actual x-ray image while receiving the explanation. After watching the videos, participants completed surveys about their thoughts and feelings regarding the condition.
The results were striking. People who saw the x-ray image were more likely to believe they would eventually need surgery. They were also more worried about moving their knee and more concerned that exercise could cause further damage.
In addition, they reported higher levels of concern about their condition overall. Although some participants felt more satisfied after seeing the image, the scan appeared to increase fear and anxiety.
These findings suggest that unnecessary x-rays may unintentionally create negative beliefs about osteoarthritis.
When people see physical changes on a scan, they may assume their knee is badly damaged, even though the image does not necessarily reflect their level of pain or future outlook. This can make people avoid movement and exercise, which are actually among the most effective ways to manage the condition.
The study highlights the importance of focusing on symptoms and practical treatment strategies rather than relying too heavily on medical images. Avoiding unnecessary scans may help reduce anxiety, lower healthcare costs, limit exposure to radiation, and prevent people from considering surgery before it is truly needed.
If you have knee osteoarthritis, it may be helpful to talk with your doctor about whether an x-ray is necessary in your situation.
In many cases, understanding your symptoms and following proven treatments such as exercise, education, and healthy lifestyle changes can be more important than what appears on a scan. For many people, these simple steps can make a meaningful difference and help them stay active and independent for longer.
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