From the Research
Subchondral sclerosis is a thickening of the bone beneath the cartilage in a joint, visible as increased bone density on X-rays, and is typically associated with osteoarthritis, developing as a result of ongoing joint stress and cartilage deterioration 1. This condition occurs when the body responds to joint damage by increasing bone production in the subchondral area, prompting it to become denser and harder as a protective mechanism. As cartilage wears away, the underlying bone experiences increased pressure and friction, leading to subchondral sclerosis.
Causes and Associations
Subchondral sclerosis is often associated with osteoarthritis, and its development is influenced by factors such as joint stress, cartilage deterioration, and increased bone production in the subchondral area 2. The subchondral bone tissue plays a significant role in the progression and/or initiation of osteoarthritis, producing proinflammatory cytokines and growth factors that contribute to cartilage tissue remodeling.
Symptoms and Treatment
Subchondral sclerosis often causes joint pain, stiffness, and reduced range of motion. Treatment generally focuses on managing the underlying osteoarthritis through pain medications like NSAIDs, physical therapy to strengthen surrounding muscles, weight management to reduce joint stress, and in severe cases, surgical interventions such as joint replacement 3, 4. Intra-articular hyaluronic acid injections are also a viable therapeutic option for treating knee osteoarthritis and suppressing inflammatory responses 3.
Management and Recommendations
The management of subchondral sclerosis should prioritize the treatment of underlying osteoarthritis, with a focus on pain management, physical therapy, and lifestyle modifications to reduce joint stress 1. Acetaminophen and NSAIDs are commonly used for pain management, although their efficacy and safety profiles should be carefully considered, particularly in patients with certain comorbidities 5.