Ace the Rheumatology Challenge 2026: Flex Your Knowledge Muscles!

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Which statement about knee osteoarthritis is true?

Osteophytes are not seen on radiographs in OA

In OA there is usually inflammatory synovitis with high ESR

Radiographs show osteophytes and joint space narrowing

Radiographic hallmarks of knee osteoarthritis are osteophyte formation at the joint margins and narrowing of the joint space from cartilage loss. These features reflect the degenerative changes in OA, where cartilage wears away and the surrounding bone responds by forming new bony growths (osteophytes) and becoming denser (subchondral sclerosis) as the joint is used. OA is not driven by a high inflammatory process, so systemic inflammatory markers like ESR are usually normal rather than elevated. Erosions, which indicate inflammatory erosive arthritis such as rheumatoid disease, are not typical in OA. Therefore, seeing osteophytes together with joint space narrowing on knee radiographs best fits osteoarthritis.

Erosions are typical in OA of the knee over time