20/02/2026
Same patient, same day. 1st X-rays shows well maintained space between the bones indicating limited arthritis. The second X-ray show bone on bone severe arthritis.
What’s the difference? This highlights the importance of what can happen in our research and clinical practices if we don’t design our protocols properly. The second X-ray is when the patient bends their knee about 30-45 degrees (rosenburg/tunnel/notch view) bringing into profile the area where we would expect maximum Cartilage damage. The challenge is the first X-ray is what we use for our typical knee research protocols. Many patients can get enrolled into research protocols who may not be candidates which impacts the results of the study. When it comes to patient care it becomes constant trial and error to see what works because the diagnostic tool is not matching the patient’s symptoms.