Knee osteoarthritis is one of the most common causes of long-lasting pain and disability.
More than two million Australians live with the condition, and it can make simple activities such as walking, climbing stairs, or getting out of a chair much harder.
Although many people think an x-ray is needed to confirm the diagnosis, doctors can usually identify knee osteoarthritis without one.
A new study published in PLOS Medicine suggests that unnecessary x-rays may do more than increase healthcare costs. They can also change how people think about their condition, making them more worried about their joints and more likely to believe they need surgery even when other treatments may work well.
Osteoarthritis develops when a joint responds to years of use, injury, or other stress. It affects the entire joint, including cartilage, bone, ligaments, and nearby muscles. Older age, previous knee injuries, and carrying excess body weight all increase the risk of developing the condition.
The most common symptoms are joint pain, stiffness after resting, and difficulty with everyday movement.
Many people worry that the pain means their knee is wearing out, but pain does not always match the amount of change seen inside the joint. Some people with severe changes on an x-ray have little pain, while others with only mild changes experience significant discomfort.
Because of this, medical guidelines recommend that doctors diagnose knee osteoarthritis mainly by asking about symptoms and performing a physical examination.
In adults over 45 who have activity-related knee pain and morning stiffness lasting less than 30 minutes, an x-ray is usually unnecessary unless another problem is suspected.
Despite these recommendations, around half of Australians who visit a general practitioner for knee osteoarthritis are still referred for imaging. These unnecessary scans are estimated to cost the Australian healthcare system more than 100 million dollars every year, while also exposing people to radiation that often provides little additional benefit.
To understand how x-rays influence patients, researchers recruited 617 adults from across Australia. Participants watched one of three videos showing a doctor diagnosing knee osteoarthritis. One group saw a consultation without an x-ray, another heard that an x-ray had been taken but did not see the image, and the third group was shown the x-ray during the consultation.
After watching the videos, participants completed questionnaires about their beliefs. People who saw the x-ray were more likely to think surgery would be necessary. They were also more worried that exercise could damage their knee, believed their condition would become worse, and felt more fearful about moving the joint.
Interestingly, those who saw the x-ray reported being slightly more satisfied with the consultation. The researchers believe this may be because many people still think osteoarthritis is simply caused by ‘wear and tear’ and expect to see visible damage before accepting a diagnosis. However, this belief can increase fear and encourage unnecessary treatment decisions.
The findings published in PLOS Medicine suggest that avoiding unnecessary x-rays may help reduce anxiety, encourage people to stay active, and lower the chance of choosing surgery before it is truly needed.
Most people with knee osteoarthritis can successfully manage their symptoms with education, regular exercise, weight management when appropriate, and medicines recommended by their healthcare provider.
If you care about health, please read studies about extra virgin olive oil for arthritis, and pomegranate: A natural treatment for rheumatoid arthritis.
For more health information, please see recent studies about how to live pain-free with arthritis, and results showing medical cannabis may help reduce arthritis pain, back pain.
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