Kellgren and Lawrence system for classification of osteoarthritis

The Kellgren and Lawrence system is a common method of classifying the severity of osteoarthritis (OA) using five grades.

The original paper graded OA at the following sites and projections:

  • hands: posteroanterior
  • cervical spine: lateral
  • lumbar spine (facet joints only): lateral
  • hips: anteroposterior
  • knees: anteroposterior
  • feet: anteroposterior

Classification

Numerous variations of the Kellgren and Lawrence classification system have been used in research . Below is the original description :

  • grade 0 (none): definite absence of x-ray changes of osteoarthritis
  • grade 1 (doubtful): doubtful joint space narrowing and possible osteophytic lipping
  • grade 2 (minimal): definite osteophytes and possible joint space narrowing
  • grade 3 (moderate): moderate multiple osteophytes, definite narrowing of joint space and some sclerosis and possible deformity of bone ends
  • grade 4 (severe): large osteophytes, marked narrowing of joint space, severe sclerosis and definite deformity of bone ends

Osteoarthritis is deemed present at grade 2 although of minimal severity .

History and etymology

This classification was proposed by Kellgren & Lawrence in 1957 and later accepted by the World Health Organization (WHO) in 1961 as the radiological definition of OA for the purpose of epidemiological studies .

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