Arthrosis and Arthritis at the Board: Joint Space Width

Bones, joints and spine

Reviewed by the LabReadAI medical team
Arthrosis and Arthritis at the Board: Joint Space Width

The short answer: with arthrosis, millimetres decide. Article 65 of the Schedule of Diseases assesses neither the "grade" from a report nor complaints, but the width of the radiographic joint space — and it sets precise numbers for it. Arthritis, meanwhile, falls under the neighbouring article 64, where the logic differs and the requirements are stricter.

Which fitness category arthrosis yields

Article 65 is titled "Surgical diseases and lesions of bones, large joints and cartilage".

What the records show Clause Column I (conscription)
Severe deforming arthrosis: narrowing of more than two thirds «a» D — unfit
Deforming arthrosis of one large joint: narrowing of one third to two thirds (2–4 mm) «b» V — limited fitness
Minor functional impairment «v» V — limited fitness
Objective findings without functional impairment «g» B-3 — fit with restrictions

The millimetres that decide

The wording for clause «b»:

deforming arthrosis in one of the large joints (narrowing of the radiographic joint space by one third to two thirds (to a width of 2–4 mm in the standing position for hip and knee joints), moderate subchondral osteosclerosis…

And for clause «a»:

severe deforming arthrosis (uneven narrowing of the radiographic joint space exceeding two thirds (joint space width on a functional radiograph in the standing position under weight bearing…

Two practical consequences. First, the image must be taken standing under weight bearing — lying down the space looks different. Second, the report must state the joint space width in millimetres, not merely the word "arthrosis" or "grade two".

Why "grade of arthrosis" is not what the board seeks

Clinical grading systems for arthrosis are not mentioned in article 65. The regulation works with joint space width, subchondral osteosclerosis and functional impairment. An entry reading "grade 2 arthrosis" therefore does not by itself allow the case to be assigned to a clause: millimetres and a description of joint function are needed.

Arthritis: article 64 and different logic

Inflammatory joint diseases are assessed separately, under article 64, "Arthritis and arthropathies of infectious, inflammatory and autoimmune origin, systemic connective tissue diseases". It covers rheumatoid arthritis, ankylosing spondylitis, reactive and psoriatic arthritis, and systemic connective tissue disease.

What the records show Clause Column I (conscription)
Significant functional impairment, persistent and pronounced changes «a» D — unfit
Moderate functional impairment and frequent flares «b» D — unfit
Minor functional impairment and rare flares «v» V — limited fitness

Note that under article 64 category D begins already at clause «b», whereas in article 65 clause «b» gives V. The regulation treats inflammatory arthritis more strictly than degenerative disease.

What the diagnosis involves and how it is confirmed is covered in the piece on rheumatoid arthritis.

Gout: also article 64

The regulation places it there directly:

In chronic infectious and inflammatory arthritis, chronic gouty arthritis, and the chronic course of the cutaneous-articular form of haemorrhagic vasculitis, the fitness category is determined under clauses «a», «b» or «v»…

Gout is therefore assessed not by uric acid levels but by joint impairment and flare frequency, like any chronic arthritis. Raised uric acid without joint manifestations does not trigger the article; what the value means on its own is covered in the piece on uric acid.

What your records must contain

  • A weight-bearing standing radiograph of the joint with the joint space width in millimetres.
  • A note on subchondral osteosclerosis and marginal outgrowths.
  • An assessment of joint function: range of movement, restrictions.
  • For arthritis — laboratory confirmation: inflammatory markers, rheumatoid factor, and uric acid for gout; which tests are taken for joint pain is collected separately.
  • A history of flares with dates — for article 64 frequency decides the clause.
  • The chart code is M17 for knee arthrosis and M13 for other arthritis.

What is usually missing

  • The image was taken lying down rather than standing under load.
  • The report gives no joint space width in millimetres, only "narrowing".
  • It states a "grade of arthrosis", which the regulation does not use.
  • Arthrosis and arthritis are not separated — different articles with different outcomes.
  • For gout there is only a uric acid result and no description of joint flares.
  • Flare frequency is not stated, although for article 64 it determines the clause.

Questions for your doctor

  • What is the joint space width in millimetres on a standing image?
  • Is there subchondral osteosclerosis and marginal outgrowths?
  • Is my diagnosis arthrosis or arthritis, and under which article is it assessed?
  • How many flares are documented over the past year?
  • How is the range of movement described?

Joints at departmental boards

The above concerns assessment under Government Decree No. 565. The Interior Ministry, National Guard, Federal Security Service and Emergencies Ministry use their own schedules of diseases with their own requirements. A review under articles 64 and 65 shows how complete your records are but is not their regulation.

The short version

With arthrosis the board looks at the image and seeks a number: 2–4 mm of joint space standing gives category V, narrowing beyond two thirds gives D, objective signs without functional impairment give B-3. With arthritis article 64 applies, and it is stricter: category D begins already at moderate impairment with frequent flares. Gout is assessed there too — by the joints, not by uric acid. Only the military medical board determines the fitness category.

Frequently asked questions

  • It depends on the joint space width on a standing image. Narrowing of one third to two thirds — a width of 2–4 mm for hip and knee joints — is clause «b» of article 65 and category V. Narrowing beyond two thirds gives category D. Objective signs of arthrosis without functional impairment are clause «g» and category B-3, meaning you serve.

  • Little on its own. Article 65 does not use clinical grades of arthrosis: it works with radiographic joint space width, subchondral osteosclerosis and functional impairment. The imaging report must therefore state millimetres, otherwise the case cannot be assigned to a clause.

  • Because the regulation explicitly requires the joint space width to be measured on a functional radiograph taken standing under weight bearing. Under body weight the space narrows, and the result differs from a supine image. The same logic applies to flat feet, where X-rays are also taken under load.

  • No, and the difference is substantial. Arthrosis is article 65, where clause «b» gives category V. Inflammatory arthritis is article 64, where category D begins already at clause «b» — moderate functional impairment with frequent flares. What inflammatory joint disease involves is covered in the piece on rheumatoid arthritis.

  • The regulation places chronic gouty arthritis directly under the clauses of article 64 — assessed by joint impairment and flare frequency. With minor impairment and rare flares that is category V; with moderate impairment and frequent flares, D. The uric acid level does not determine the category by itself.

  • No. Asymptomatic hyperuricaemia is a laboratory finding, not a joint disease, and does not trigger article 64. What matters is confirmed arthritis flares and their frequency. What the value shows and why it rises is covered in the piece on uric acid.

  • No, spinal involvement is assessed under article 66 with its own criteria: number of affected segments, anatomical signs and documented pain. Article 65 concerns the large joints of the limbs. Which joint the report describes therefore matters.

  • Find two facts in the imaging report: whether it was taken standing under load, and whether the joint space width is stated in millimetres. If so, compare it with the 2–4 mm threshold. For arthritis add the number of flares per year. The completeness of what you have can be checked with a review against the Schedule of Diseases.

#Schedule of Diseases#Code M17#Tests for joint pain#Rheumatoid arthritis

For informational purposes only

This article is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Please consult a healthcare professional for medical guidance.

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