The work is focused on the recent advances in the development of contrast agents for optical diagnostics of early osteoarthritis (OA). Optical imaging provides the high spatial resolution and may be useful for evaluation of submicron degenerative changes of cartilage structure unavailable for diagnosis by conventional radiography and magnetic resonance tomography (MRT). To increase the contrast and sensitivity of optical signal the specific absorbing additives are being developed: targeted and non-targeted fluorescent probes, functionalized metallic and polymeric nanoparticles (NPs). Sometimes the diagnostic and therapeutic potentials are bringing together in one substance thus providing increased effectiveness of the early prevention of OA. Also, the theoretical aspects of selective binding mechanisms to the tissue degenerative sites are briefly concerned.