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As the nation’s #1 cause of disability, arthritis affects nearly 60 million adults and 300,000 children. Over 100 types of arthritis and related conditions damage the joints and often other organs.

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Why MRIs Aren’t Always Enough to Predict Knee Osteoarthritis

Why MRIs Aren’t Always Enough to Predict Knee Osteoarthritis

November 02, 20242 min read

If you or someone you love struggles with knee pain, you may have heard about knee osteoarthritis (OA). It’s a common condition that causes joint pain, stiffness, and swelling over time. Detecting it early is important because starting treatment or making lifestyle changes can help slow the progression of the disease.

However, new research reveals that MRI scans alone may not be enough to predict which knees will develop significant osteoarthritis in the future. While MRIs are advanced tools that show detailed images of your joints, they don’t always tell the full story.


The Research: What Did They Find?

In a recent study, researchers looked at over 1,600 adults to see how well MRI scans could predict the development of osteoarthritis over 11 years. They tested two ways to define OA using MRIs:

  1. A detailed approach that looked at cartilage damage, bone spurs, and other joint changes.

  2. A simpler approach that focused only on cartilage damage and bone spurs.

The Surprising Results:

  • While MRIs identified 17-24% of participants as having signs of knee OA, more than 50% of those people never developed osteoarthritis visible on X-rays.

  • In fact, 59% to 64% of participants with MRI signs of OA never progressed to significant OA over the next decade.


What Does This Mean for You?

This study shows that MRIs may pick up early joint changes, but those changes don’t always mean you’ll develop serious knee osteoarthritis. In other words, just because an MRI finds small signs of damage doesn’t guarantee that your joint will worsen or cause major problems.

Dr. Alison Chang, one of the researchers, explains:

“MRI alone doesn’t give us the full picture of what’s happening with knee osteoarthritis.”

This finding is important because it highlights the need to look at more than just images to predict who will develop knee OA. Doctors need to combine MRI results with:

  • Physical exams

  • Symptoms like pain and stiffness

  • Other risk factors, like weight, genetics, and activity levels


What’s Next? A Better Way to Predict OA

The study suggests that to better predict knee osteoarthritis, doctors and researchers need to take a more complete approach. This might include:
✅ Developing new tools that combine MRI images with physical exams and patient symptoms.
✅ Using artificial intelligence (AI) and other advanced technologies to improve accuracy.
✅ Finding new ways to identify early warning signs of knee OA, like blood tests or other biomarkers.

By combining all this information, doctors will be able to identify at-risk patients earlier and help prevent severe joint damage.


The Bottom Line

MRIs are powerful tools, but they don’t tell the full story when it comes to predicting knee osteoarthritis. If you’re experiencing knee pain, it’s important to work closely with your doctor to evaluate all the signs—not just what shows up on an MRI.

Early intervention and lifestyle changes, like staying active and maintaining a healthy weight, can make a big difference in managing knee OA and protecting your joints.

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Effects of Arthritis

Cause of Disability

In the United States, 23% of all adults, or more than 54 million people, have arthritis. It is a leading cause of work disability, with annual costs for medical care and lost earnings of $303.5 billion.

Workforce Effects

Sixty percent of US adults with arthritis are of working age (18 to 64 years). Arthritis can limit the type of work they are able to do or keep them from working at all.

Global Impact

In fact, 8 million working-age adults report that their ability to work is limited because of their arthritis. For example, they may have a hard time climbing stairs or walking from a parking deck to their workplace.

Promoting Interventions That Reduce Arthritis Pain

American Arthritis Foundation recognizes several proven approaches to reduce arthritis symptoms:

  • Be active. Physical activity—such as walking, bicycling, and swimming—decreases arthritis pain and improves function, mood, and quality of life. Adults with arthritis should move more and sit less throughout the day. Getting at least 150 minutes of moderate-intensity physical activity each week is recommended.

  • Protect your joints. People can help prevent osteoarthritis by avoiding activities that are more likely to cause joint injuries.

  • Talk with a doctor. Recommendations from health care providers can motivate people to be physically active and join a self-management education program. Should your arthritis be interfering with your activities of daily living you may be a candidate to receive many new treatments, and learn how to reverse the arthritis condition.

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