Grades of osteoarthritis by Kellgren and Lawrence

Grading of joint osteoarthritis by Kellgren and Lawrence uses plain radiograph to assess the extent of degenerative disease. Originally, the authors assessed degenerative joint disease on a single x-ray view: AP for hips, knees, and feet, lateral view for cervical and lumbar spine, and PA view for hands. In the following studies, several mutations of this classification were used.

Grade - Changes Description
Grade 0 - None no changes
Grade I - Doubtful doubtful narrowing of joint space and possible osteophytic lipping
Grade II - Minimal definite osteophytes, definite narrowing of joint space
Grade III - Moderate moderate multiple osteophytes, definite narrowing of joint space, some sclerosis and possible deformity of bone contour
Grade IV - Severe large osteophytes, marked narrowing of joint space, severe sclerosis and definite deformity of bone contour


1. Schiphof D, Boers M, Bierma-Zeinstra SMA. Differences in descriptions of Kellgren and Lawrence grades of knee osteoarthritis. Ann. Rheum. Dis. 2008 Jul;67(7):1034–6.
2. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann. Rheum. Dis. 1957 Dec;16(4):494–502.

3. Petersson I, Boegard T, Saxne T, Silman A, Svensson B. Radiographic osteoarthritis of the knee classified by the Ahlb?ck and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis. 1997 Aug;56(8):493–6.