Lumbar osteoarthritis: the diagnosis

The diagnosis of lumbar osteoarthritis is based on radiography.

The radiography associates, to varying degrees:

  • A pinch of the disc is discarthrosis, which reflects the destruction of the cartilage;
  • Densification (or condensation) of the bone under the cartilage on the vertebral plateaus;
  • Hypertrophy of the bone at the bone-cartilage junction (this is the "osteophyte", or "parrot's beak" in common parlance).

Osteophytosis is the most common radiographic lesion seen in lumbar osteoarthritis.

Some radiological reports have, unintentionally, a very negative impact: the words "degenerative", "evolved", "staged" refer to a feeling of irremediability. Do not hesitate to share your concerns with your doctor

Modern imaging techniques can be useful for the diagnosis of lumbar osteoarthritis, especially for assessing its impact or for discussing the achievement of infiltration. The scanner, allowing horizontal cuts, has a certain interest for the study of certain joints poorly explored otherwise (posterior articular). Magnetic resonance imaging (MRI) is a second-line examination to evaluate a narrowed lumbar canal, or where there is a discrepancy between symptom severity and radiography.

At what rate should X-rays be repeated to follow the course of lumbar osteoarthritis?

There is no consensus on this. If the symptomatology does not change, there is no point in renewing the examination. If an aggravation occurs, it may be useful to repeat the X-rays and / or complete them with CT or MRI. In all cases, it is necessary to report to your doctor the successive photographs, which alone allow to appreciate a possible evolution.

It is currently the simple radiography that allows the diagnosis of lumbar osteoarthritis and to follow the evolution. CT or MRI are second-line examinations, which can be indicated in cases of diagnostic difficulty, before an infiltration procedure, or to discuss an intervention.

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