Kellgren-Lawrence Grading Scale

Radiographic classification of osteoarthritis severity based on joint space narrowing, osteophytes, sclerosis, and bone deformity on plain radiographs.

Instructions:

Review the weight-bearing radiograph and select the Kellgren-Lawrence grade that best describes the overall osteoarthritis severity for this joint. Radiographic osteoarthritis is typically defined as minimal grade or higher.

Radiographic Grading

Select the Kellgren-Lawrence grade based on the radiograph

None: Physiological joint with healthy cartilage. Well-preserved space, no bone spurs, and no sclerosis

Doubtful: Doubtful joint space narrowing with possible small, early osteophytes (bone spurs)

Minimal: Definite osteophytes and possible, early joint space narrowing

Moderate: Multiple, moderate osteophytes, definite joint space narrowing, early bone sclerosis, and possible bone deformity

Severe: Large osteophytes, marked or complete collapse of the joint space, severe bone sclerosis, and definite deformity of bone ends (bone-on-bone)

Osteoarthritis is typically defined radiographically at minimal grade or higher.

Patient Watch Form - 6/2/2026