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2015 ; 17
(ä): 270
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Bone marrow lesions can be subtyped into groups with different clinical outcomes
using two magnetic resonance imaging (MRI) sequences
#MMPMID26410822
Wluka AE
; Teichtahl AJ
; Maulana R
; Liu BM
; Wang Y
; Giles GG
; O'Sullivan R
; Findlay D
; Cicuttini FM
Arthritis Res Ther
2015[Sep]; 17
(ä): 270
PMID26410822
show ga
INTRODUCTION: Bone marrow lesions (BMLs) are features detected on MRI that are
important in the pathogenesis of knee osteoarthritis. Since BMLs reflect
heterogeneous pathologies this prospective cohort study examined whether BMLs
detected using different MRI sequences are associated with distinct structural
and clinical endpoints. METHODS: A total of 297 community-based adults without
knee pain were examined to identify BMLs visualised using three-dimensional
T1-weighted gradient-echo fat-suppressed (T1-weighted sequences) fat-suppressed
and fat-saturated FSE T2-weighted MRI sequences (T2-weighted sequences) at
baseline. Cartilage volume was measured at baseline and follow-up, while incident
knee pain was assessed at follow-up, an average of 2.3 years later. RESULTS: At
baseline, 46 BMLs were visualised in 39 participants. Of the 45 BMLs visualised
on T2-weighted sequences, 34 (74%) were also seen on T1-weighted sequences. One
BML was seen on only T1-weighted sequences. Knees with BMLs visualised on both
T1- and T2-weighted sequences had significantly higher medial tibial cartilage
volume loss (45 mm3/annum, standard error of the mean (SEM) 14) than those with
BMLs identified on only T2-weighted sequences (-13 mm3/annum SEM 19), after
adjustment for age, gender and body mass index (p?=?0.01). Incident knee pain was
more likely in individuals with BMLs in the medial compartment visualised on both
T1- and T2-weighted (eight participants, 53%) compared to those with BMLs on only
T2-weighted sequences (0%) or no BMLs (76 participants, 31%, p?=?0.02).
CONCLUSIONS: BMLs present on both T1- and T2-weighted MRI sequences were
associated with increased medial tibial cartilage loss and incident knee pain
compared with those BMLs seen only on T2-weighted sequences. This suggests that
combining different MRI sequences may provide more informative targets in the
prevention and treatment of knee osteoarthritis.