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Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging
Journal article   Open access   Peer reviewed

Correlation of the development of knee pain with enlarging bone marrow lesions on magnetic resonance imaging

David T Felson, Jingbo Niu, Ali Guermazi, Frank Roemer, Piran Aliabadi, Margaret Clancy, James Torner, C Elizabeth Lewis and Michael C Nevitt
Arthritis and rheumatism, Vol.56(9), pp.2986-2992
09/2007
DOI: 10.1002/art.22851
PMID: 17763427
url
https://doi.org/10.1002/art.22851View
Published (Version of record) Open Access

Abstract

Results of cross-sectional studies have suggested that bone marrow lesions (BMLs) visualized on magnetic resonance imaging (MRI) are related to knee pain, but no longitudinal studies have been done. This study was undertaken to determine whether enlarging BMLs are associated with new knee pain. Subjects ages 50-79 years with knee osteoarthritis (OA) or at high risk of knee OA were asked twice at baseline about the presence of knee pain, aching, or stiffness (classified as frequent knee pain) on most days; absence of knee pain was the baseline eligibility criterion. At 15 months' followup, subjects were again queried twice about frequent knee pain. A case knee was defined as absence of knee pain at baseline but presence of knee pain both times at followup. Controls were selected randomly from among knees with absence of pain at baseline. All MR images were scored for volume of BMLs in the medial, lateral, and patellofemoral compartments. We focused on the maximal change in BML score among the knee compartments from baseline to 15 months. Multiple logistic regression, with adjustments for demographic and clinical variables, was used to assess whether an increased BML score is predictive of the development of knee pain. Among case knees, 54 of 110 (49.1%) showed an increase in BML score within a compartment, whereas only 59 of 220 control knees (26.8%) showed an increase (P < 0.001 by chi-square test). A BML score increase of at least 2 units was much more common in case knees than in control knees (27.5% versus 8.6%; adjusted odds ratio 3.2, 95% confidence interval 1.5-6.8). Among case knees with increased BMLs, most already had BMLs at baseline, with enlarging BMLs at followup, but among the subset of knees with no BMLs at baseline, new BMLs were more common in case knees (11 [32.4%] of 34) than in control knees (9 [10.8%] of 83). Development of knee pain is associated with an increase in BMLs as revealed on MRI.
 Arthralgia - etiology Bone Marrow Diseases - complications Bone Marrow Diseases - diagnosis Magnetic Resonance Imaging Follow-Up Studies Knee Joint Humans Middle Aged Female Male Aged Arthralgia - diagnosis

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