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Natural history and clinical significance of MRI-detected bone marrow lesions at the knee: a prospective study in community dwelling older adults

Citation

Dore, D and Quinn, S and Ding, C and Winzenberg, T and Zhai, G and Cicuttini, F and Jones, G, Natural history and clinical significance of MRI-detected bone marrow lesions at the knee: a prospective study in community dwelling older adults, Arthritis Research & Therapy, 12, (6) EJ ISSN 1478-6354 (2010) [Refereed Article]

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Copyright Statement

© 2010 Dore et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Official URL: http://arthritis-research.com/content/12/6/R223

DOI: doi:10.1186/ar3210

Abstract

Introduction: There are conflicting data on the natural history and clinical significance of bone marrow lesions (BMLs). The aims of this study were to describe the natural history of MRI-detected BMLs at the knee using a quantitative measure and examine the association of BMLs with pain, function and stiffness scores, and total knee replacement (TKR) surgery. Methods: A total of 395 older males and females were randomly selected from the general population (mean age 63 years, range 52 to 79) and measured at baseline and approximately 2.7 years later. BMLs were determined using T2-weighted fat saturation MRI by measuring the maximum area of the lesion. Reproducibility was excellent (intraclass correlation coefficient (ICC): 0.97). Pain, function, and stiffness were assessed by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scores. X-ray was used to assess radiographic osteoarthritis (ROA) at baseline. Results: At baseline, 43% (n = 168/395) had a BML. Of these 25% decreased in size and 24% increased. Of the remaining sample (n = 227), 7% developed a new BML. In a multivariable model, a change in BML size was associated with a change in pain and function scores (b = 1.13 to 2.55 per 1 SD increase, all P < 0.05), only in those participants without ROA. Lastly, baseline BML severity predicted TKR surgery (odds ratio (OR) 2.10/unit, P = 0.019). Conclusions: In a population based sample, BMLs (assessed by measuring maximal area) were not static, with similar proportions both worsening and improving. A change in BML size was associated with changes in pain in those without established ROA. This finding suggests that fluctuating knee pain may be attributable to BMLs in those participants with early stage disease. Baseline BMLs also predicted TKR surgery. These findings suggest therapeutic interventions aimed at altering the natural history of BMLs should be considered.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
UTAS Author:Dore, D (Associate Professor Dawn Aitken)
UTAS Author:Quinn, S (Dr Stephen Quinn)
UTAS Author:Ding, C (Professor Chang-Hai Ding)
UTAS Author:Winzenberg, T (Professor Tania Winzenberg)
UTAS Author:Jones, G (Professor Graeme Jones)
ID Code:66743
Year Published:2010
Web of Science® Times Cited:81
Deposited By:Menzies Institute for Medical Research
Deposited On:2011-02-10
Last Modified:2011-05-03
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