What Is Subchondral Sclerosis?

Abnormal Bone Remodeling in Late Osteoarthritis

Two medical professionals reviewing an xray

 Tripod/Getty Images

Subchondral sclerosis is a thickening of the bone in joints. It can affect people who have osteoarthritis and result in painful bone spurs. Fortunately, subchondral sclerosis is easily detected, and there are several treatment options available. Subchondral sclerosis is commonly seen in joints of the knee, hip, spine, and foot.

Symptom and Causes

To understand what subchondral sclerosis is, it helps to have a clear picture of how osteoarthritis affects the joints of the body. Not only does osteoarthritis degrade the cartilage in a joint, it also wears away at the subchondral bone underneath the cartilage.

As the body tries to regrow (remodel) this bone, it comes back thicker than before, resulting in subchondral sclerosis. It is most commonly detected in the later stages of osteoarthritis.

Subchondral sclerosis can cause painful bone spurs and, in some cases, reduce the range motion in the affected joint. The loss of height is also common, especially if the knee, hip, or spine are affected. When occurring in the knee, the locking of the joint can sometimes occur.

Risk factors for subchondral sclerosis include genetic predisposition, female gender, older age, obesity, previous joint injury, joint malalignment, or abnormal joint shape.

Women are more likely to get subchondral sclerosis more than men, with 18 percent over 60 likely to develop the condition. On the flip side, men are more likely to develop subchondral sclerosis under the age of 50.

Diagnosis

When you have an X-ray as part of the diagnostic process for osteoarthritis, subchondral sclerosis is one of the things the radiologist looks for and observes. It shows up on X-ray as a denser area of bone just under the cartilage in your joint, appearing as abnormally white bone along the joint line. Magnetic resonance imaging (MRI) may also be ordered as it is better at imaging soft tissue damage.

The presence of subchondral sclerosis can in no way predict how your osteoarthritis will progress. You should not assume that your condition is worsening if subchondral sclerosis is diagnosed.

In fact, a study published in Osteoarthritis and Cartilage suggests that subchondral sclerosis may prevent cartilage loss in people with varus knee osteoarthritis. According to the researchers, the overgrowth of bone may sometimes help realign bowed knee joints and prevent excessive abrading.

Another study published in 2014 similarly found no significant association between baseline subchondral sclerosis and an increased risk of cartilage loss in the knee.

Treatment

Much like osteoarthritis, there is no cure for subchondral sclerosis. But, there are steps you can take to slow its progression and reduce painful symptoms.

Low-impact physical exercise, including using a stationary bike, yoga, and swimming are excellent ways to keep the affected joints active. In people who are overweight, losing weight is also recommended as a way to reduce stress on their joints.

Your doctor may also recommend physical therapy, hydrotherapy, or more holistic medical treatments, such as acupuncture. Anti-inflammatory medications, such as ibuprofen, also may be recommended.

For more serious cases, there are prescription medications which may help to provide relief. In general, anything that relieves osteoarthritis symptoms will help subchondral sclerosis symptoms as well.

In some severe cases, surgery to remove the excess bone growth may be recommended. As with any chronic condition, consult with your doctor to determine the best course of treatment for your symptoms.

A Word From Verywell

Subchondral bone is more than an image on an X-ray. It is involved with and is affected by what is happening with the cartilage in a joint. When cartilage is thinned in osteoarthritis, the bone reacts. You can keep your joints as healthy as they can be by low-impact exercise and physical therapy.

Was this page helpful?
Article Sources
  • Akamatsu, Y.; Kobayashi, H.; Kusayama, Y. et al. Does subchondral sclerosis protect progression of joint space narrowing in patients with varus knee osteoarthritis? Osteoarthritis Cartilage. 2014;22(Supplement): S362. DOI: 10.1016/j.joca.2014.02.667.

  • Crema M, Cibere J, Sayre E, et al. The relationship between subchondral sclerosis detected with MRI and cartilage loss in a cohort of subjects with knee pain: the knee osteoarthritis progression (KOAP) study. Osteoarthritis and Cartilage. 2014;22(4):540-546. doi:10.1016/j.joca.2014.01.006.

  • Li G, Yin J, Gao J, et al. Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Research & Therapy. 2013;15(6):223. doi:10.1186/ar4405.