We took our 18-year-old daughter to see a doctor for knee pain. After an exam, X-ray, and MRI, she was given a diagnosis of grade two articular cartilage defect. Was it really necessary to do so much testing to figure this out?

A specific diagnosis is needed before treatment can be determined. Results of treatment for this type of problem are best if the right treatment is applied.

In the case of the knee joint, X-rays should include several views. Standing upright and 45-degree knee flexion in standing are usually taken. A special lateral view (from the side) and sunrise view of the kneecap may also be taken.

X-rays show small changes in the joint space and any defects of the cartilage where it meets the bone. Bone cysts and bone spurs can also be seen on X-rays.

MRIs are helpful in locating other structures of the knee that might be damaged. Poor alignment, meniscal deficiency, and ligament instability are identified with MRI. Repair of these injuries must be done for a successful result.

A thorough examination of this type is, indeed, needed in order to plan the correct treatment for the best result.