X-ray for bone on bone- One picture that is worth only one word- FALSE.

Almost on a daily basis I encounter somebody that has been told that their knee or hip is bone on bone strictly as a result of an x-ray that showed no joint space. From this point forward, I want anybody who sees this post to spread this proclamation; THE X-RAY IS NOT ABLE TO SEE WHETHER YOU ARE BONE OR BONE OR NOT. Now clearly, the x-ray is showing that there is a decrease in the joint space of that joint. This is undeniable. But to imply that you are bone on bone is to imply that there isn’t even 1/100 of an inch of space still available to separate the bones. This is critical to understand because the purpose of the joint space is to allow the bones that make up a joint to be able to glide on one another to allow the individual to actively be able to move the joint through normal range of motion. If there is NO joint space then there could be no glide and if there is no glide then a major loss of range of motion should be experienced whether the person moves the joint or somebody else does and there should be a feeling that a bone is pushing against another bone at this point where joint range of motion ends.
In the vast majority of cases I have treated where somebody was told they were bone on bone full range of motion if not almost completely full range of motion was presented. This indicated that the joint was not bone on bone no matter how much joint space was lost.
Range of motion is the determining factor whether a joint is bone on bone. The x-ray is nothing more than an image of what exists. You must look at how the joint actually moves to determine whether it is bone on bone not an image that somebody tries to interpret to achieve an end that seems to benefit them.
I am all for joint replacements when the body presents that the joint has deteriorated to where there is no joint space and the joint can’t go through full range of motion limiting function. I am not for any joint replacement where a joint goes through full range of motion and pain is not coming from the joint but from an adjacent tissue.
I know that that picture is very compelling and so is the person holding it. But you have one body and it has to be your responsibility to protect. You are getting bad information right now and that is why it is hard to get a good explanation as to why you are having pain. Just look at the information that I provide and you will see that it is an attempt to interpret what your body is trying to tell you as to what is causing your pain. Not an attempt to interpret a picture that is designed to over ride what the body is trying to present.

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