An Overview of Subchondral Sclerosis

Symptoms, causes, diagnosis, and treatment

Subchondral sclerosis is a thickening of the bone beneath the cartilage in joints. Also known as marginal sclerosis, it is most commonly found in the later stages of osteoarthritis and can be associated with painful joint symptoms and bone spurs. Subchondral sclerosis is often seen in joints of the knee, hip, spine, and foot.

Treatment for subchondral sclerosis may include exercise, physical therapy, and anti-inflammatory medications. For severe cases, surgery may be an option.

This article looks at the symptoms and causes of subchondral sclerosis. It also covers how it's diagnosed and treated.

Film x-ray both knees show narrow joint space, osteophyte, subchondral sclerosis
ChooChin / Getty Images

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. Osteoarthritis degrades the cartilage in a joint and wears away at the subchondral bone underneath the cartilage.

The body tries to repair the damaged bone. As the bone is remodeled, it comes back thicker than before, resulting in subchondral sclerosis. These changes are most commonly detected in the later stages of osteoarthritis.

Subchondral sclerosis is associated with painful bone spurs, which can reduce the range of motion of the affected joint. It can also occur when there's a deterioration of joint cartilage, which can make a person shorter—especially if the knee, hip, or spine are affected. When subchondral sclerosis occurs in the knee, the joint can also sometimes lock.

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


When the affected joint is examined with an X-ray, subchondral sclerosis can appear as a dense area of bone just under the cartilage in your joints, and it looks abnormally white bone along the joint line.

Magnetic resonance imaging (MRI) is also a good test for visualizing soft tissue damage.

The presence of subchondral sclerosis is not predictive of the progression or severity of your osteoarthritis. You should not assume that your condition is worsening if you have subchondral sclerosis.

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 the risk of cartilage loss in the knee.


There is no cure for subchondral sclerosis. But, there are steps you can take to slow the progression of underlying osteoarthritis and reduce painful symptoms.

Low-impact physical exercise, such as biking on a stationary bike, yoga, and swimming are good ways to keep your joints active. If you are overweight, losing weight is also recommended as a way to reduce stress on your joints.

Your healthcare provider may recommend physical therapy, hydrotherapy, or holistic medical treatments, such as acupuncture. And anti-inflammatory medications such as ibuprofen may be recommended.

For osteoarthritis symptoms, prescription medications may help provide relief. When symptoms are severe, joint replacement surgery may be appropriate for certain joints.

As with any chronic condition, consult with your healthcare provider to determine the best course of treatment for your condition.

A Word From Verywell

Subchondral bone and cartilage affect each other. When cartilage is thinned due to osteoarthritis, the bone often reacts. Strategies you can use to keep your joints as healthy as they can include getting regular low-impact exercise and participating in physical therapy.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. 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

  2. Crema MD, Cibere J, Sayre EC, Roemer FW, Wong H, Thorne A, Singer J, Esdaile JM, Marra MD, Kopec JA, Nicolaou S, Guermazi A. 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 Cartilage. 2014;22(4):540-6. doi:10.1016/j.joca.2014.01.006

Additional Reading

By Carol Eustice
Carol Eustice is a writer who covers arthritis and chronic illness. She is the author of "The Everything Health Guide to Arthritis."