RT Journal Article
SR Electronic
T1 Frequency of Bone Marrow Lesions and Association with Pain Severity: Results from a Population-based Symptomatic Knee Cohort
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.100587
DO 10.3899/jrheum.100587
A1 Stephen Ip
A1 Eric C. Sayre
A1 Ali Guermazi
A1 Savvakis Nicolaou
A1 Hubert Wong
A1 Anona Thorne
A1 Joel Singer
A1 Jacek A. Kopec
A1 John M. Esdaile
A1 Jolanda Cibere
YR 2011
UL http://www.jrheum.org/content/early/2011/02/24/jrheum.100587.abstract
AB Objective To evaluate the prevalence of bone marrow lesions (BML) and their association with pain severity in a population-based cohort of symptomatic early knee osteoarthritis (OA). Methods Subjects with knee pain (n = 255), age 40–79 years, were evaluated by radiograph and magnetic resonance imaging (MRI) and classified into OA stages: no OA (NOA), preradiographic OA (PROA), and radiographic OA (ROA). BML were graded 0–3 (none, mild, moderate, severe) in 6 regions and defined as (1) BMLsum = the sum of 6 scores; and (2) BMLmax = the worst score at any region. Pain was assessed by the Western Ontario and McMaster Universities OA Index (WOMAC). Linear regression analysis was completed to assess the association of Total WOMAC Pain (primary outcome) versus BMLsum or BMLmax. Secondary outcomes were WOMAC Pain on Walking and WOMAC Pain on Climbing Stairs. All analyses were adjusted for age, sex, body mass index, OA stage, joint effusion, and meniscal damage. Results BML were present in 11% of NOA, 38% of PROA, and 71% of ROA subjects (p < 0.001). No association was seen for BMLsum or BMLmax versus Total WOMAC Pain or Pain on Walking. However, BMLsum was associated with Pain on Climbing Stairs [regression coefficients (RC) = 0.09, 95% CI 0.00–0.18]. BMLmax was associated with Pain on Climbing Stairs, with the strongest association for severe BML (RC 0.60, 95% CI 0.04–1.17). Conclusion BML were present in 38% of PROA and 71% of ROA subjects in this symptomatic knee cohort. BML were significantly associated with Pain on Climbing Stairs but not Total WOMAC or Pain on Walking.