One of the most exciting possibilities with glucosamine and some of the other osteoarthritis treatments is the possibility that they can protect cartilage from damage, actually altering the course of the disease. Such a “chondroprotective agent” would be a major advance over all standard treatments.As we have already said, glucosamine is both a raw material for the production of proteoglycans, and it also seems to be able to stimulate the production of new proteoglycans and collagen. This might give the body a boost in delaying the joint destruction of osteoarthritis.Furthermore, recent evidence suggests that glucosamine can also inhibit the enzymes responsible for breaking down cartilage. This would mean that it was working from both sides, as it were, to prevent the joints from deteriorating.Unfortunately, we do not yet have any direct evidence that glucosamine really slows down osteoarthritis. What we really need are long-term studies comparing the X-ray evidence of joint damage in two groups of subjects: the first given glucosamine, the second given placebo. Until such studies are performed, the promise of chondroprotection with glucosamine will remain only a promise.*36/306/5*

If you have swelling and/or pain in your knee, your doctor will look for several causes, including destruction of the articular cartilage. Unfortunately, there is no noninvasive diagnostic test that provides a good view of articular cartilage; only an arthroscope of the area can provide a definitive answer. Very often, we try to rule out other possible problems that we can diagnose using noninvasive methods before considering the articular cartilage.
An X Ray
An X ray will not show the articular cartilage per se, but a standing X ray will show if the spaces between the joints have narrowed, which suggests an erosion of articular cartilage.

MRI
Although I believe that MRI will eventually be able to “see” articular cartilage, to date, it does not with any degree of accuracy. However, it does show whether the menisci are injured or whether any of the ligaments are torn. In addition, an MRI will show whether any bones are bruised, which could indirectly be a sign of injury to the articular cartilage.

Arthroscopy
Your physician may decide to arthroscope the knee to assess the extent of the damage or if he is convinced that there is a problem with the articular cartilage (or any other structure of the knee) that may be improved through surgical intervention.
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