BACKGROUND: Osteoarthritis (OA) is the leading cause of musculoskeletal pain and functional disability worldwide. However, the etiology of this condition is still largely unknown.

CASE REPORT: We report the clinical course of an elderly man with knee OA.

CONCLUSIONS: Plain radiographs and MRI examinations performed during follow-up suggested that the pathophysiology of the patient’s knee OA and joint pain may have been primarily due to bone alterations.

Keywords: Arthralgia - etiology, Aged, 80 and over, Diagnosis, Differential, Knee Joint, Magnetic Resonance Imaging, Osteoarthritis, Knee - complications, Pain Measurement, Physical Examination, Severity of Illness Index