My Aching Joints: When to get an X-ray

Got joint pain? If so, an X-ray may help identify the source of the problem.

Rest and over-the-counter pain relievers are often the first step to address acute joint pain. But if the pain continues or worsens, it is time to get checked by a medical professional who can determine whether an X-ray is needed.

If joint pain is chronic and associated with deformity or stiffness, then an X-ray is more likely to show changes in the joint. Sometimes joint pain can also be “referred” from an area higher in the body. For example, hip pain may come from the lower back. Shoulder pain can be referred from the neck, and knee pain can come from a bad hip. Therefore if pain is persistent, then seeing a medical professional is a good place to begin.

If an X-ray is negative, then a stronger oral medication or injection may help reduce the inflammation that is causing pain.

If swelling and pain persists, a MRI (Magnetic Resonance Image) or CT (Computerized Tomogram) scan may be useful. The tests will show more details of soft tissues, such as cartilage, ligaments, and muscle surrounding the joint.

Additionally, blood tests can identify other potential causes of the pain, such as gout, psoriatic or rheumatoid disease, or even infections.

If an X-ray detects mild to moderate arthritis, then a more conservative program of treatment may be suggested that includes basic life-style modifications. This includes diet and weight management, consistent low-stress exercises, joint injections, and bracing and supports. Additionally, physical therapy can reduce pain and improve performance, while a pain clinic can target the pain source with guided injections.

If more severe arthritis is found, then surgery may be appropriate. When arthritis is severe the bone becomes unprotected and begins to wear away. It can become deformed and makes surgery more difficult. Therefore, joint damage should be addressed sooner rather than later.

When it comes to the knee joint, knee resurfacing is a less-invasive approach than a total knee replacement. It is one of the most commonly performed orthopedic procedures with more than one million performed worldwide each year.
Knee resurfacing is similar to “capping” a tooth with only the bad surface of the bone being changed, not the entire joint. Thanks to modern biomaterials, resurfaced or replaced joints can last more than 20 years.

People who benefit from total knee replacement often have severe knee pain or stiffness that limits their everyday activities. They can have trouble walking, climbing stairs, or getting in and out of chairs.
After surgery, patients can often stand and walk within a few hours, leave the hospital within a few days, and continue exercises as an outpatient. Eighty percent recovery often occurs after a month, with a ninety-five percent recovery by two months. Driving is usually possible within two weeks. Some work activities can be resumed relatively quickly as well.

Other joints like the hip and shoulder are also now commonly replaced and quite successful with quick recoveries and long-lasting performance. These replacements, like the knee, can now last more than 20 years.