Alignment X Rays: What Are They and Why Are They Important

Knee x rays are usually the first imaging obtained when at the orthopaedic surgeon's office to evaluate knee pain. In certain situations, special x rays called "alignment x rays" may be obtained. These are special x rays that show the entire extremity of the patient.
By evaluating the entire extremity in one image, the physician can better understand the causes of a patient's knee pain.
A patient's "alignment" can be either neutral (straight), varus (bow leg), or valgus (knock knee). This is important to understand because this references the "mechanical axis" of the extremity which is essentially the main area the knee feels mechanical loading.
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Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.
All patients have been consented for use of any imaging, video, or other media.

[@ulugbekmutalipov9680]

Thank you for information doctor

[@zeeshani8284]

Can you do a video on assessing joint replacement XRs? Such as knee, hip and shoulder replacements? Thanks!

[@JeffreyWittyMD]

Thanks for the suggestion. Joint replacements (arthroplasty) is not a routine part of my practice but I can collaborate with some colleagues on such a video. Stay tuned!

[@italyhound]

Very helpful! Is correction possible with non surgical therapy or is osteotomy the first line therapy?

[@JeffreyWittyMD]

E, Thanks for the question. Surgery is really the only way to correct the actual underlying bone alignment. However, surgery is never the first line treatment. There are other options that should be considered. As always, the first thing one should do is make sure that there is a clear diagnosis and I recommend an orthopaedic surgeon to evaluate that. Once this has been established, non surgical treatments such as non steroidal anti inflammatory medications (NSAIDs) like ibuprofen are often used on an as needed basis. There are certain types of braces called "unloader" braces that will place a force on the knee that will redirect the mechanical axis and can "unload" the painful side of the knee. Therapy is often helpful to strengthen and restore range of motion in a knee/extremity that has been painful. I hope this answers your question! _______________________________________________________________________ Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure. All patients have been consented for use of any imaging, video, or other media.

[@italyhound]

@@JeffreyWittyMD thanks so much for that answer. That’s helpful. Understood it’s just an informal opinion - I’m an MD myself so appreciate the helpful information.

[@JeffreyWittyMD]

@@italyhound Great! I am glad you found it helpful. With time I hope to create content helpful to MDs as well as patients. Let me know if there are any topics you feel would be beneficial.

[@italyhound]

@@JeffreyWittyMD I definitely will - thanks!