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Bone marrow lesions in knee osteoarthritis change in 6–12 weeks
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Felson, D. T., Parkes, M. J., Marjanovic, E.J., Callaghan, M., Gait, A., Cootes, T., Lunt, M., Oldham, J. and Hutchinson, Charles E. (2012) Bone marrow lesions in knee osteoarthritis change in 6–12 weeks. Osteoarthritis and Cartilage, 20 (12). pp. 1514-1518. doi:10.1016/j.joca.2012.08.020 ISSN 1063-4584.
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Official URL: http://dx.doi.org/10.1016/j.joca.2012.08.020
Abstract
Objectives
Knee osteoarthritis (OA) is thought to be a slowly evolving disease with glacial changes in cartilage morphology necessitating trials of potential treatments lasting 1–2 years with evidence that over 6 months change in cartilage is not detectable. In contrast to cartilage, bone has the capacity to adapt rapidly, such as after fracture. We tested whether bone marrow lesions (BMLs) change in volume in 6 and 12 weeks, suggesting they may provide evidence of short term fluctuations of joint damage.
Methods
In 62 patients with patellofemoral knee OA (mean age 55.7 years, 59.7% women, mean BMI 31.0), we obtained baseline, 6 and 12 week knee MRIs with contrast enhancement. Of those with BMLs at baseline, we assessed BML volume on the axial proton density fat saturated (FS) images and postcontrast sagittal T1 weighted FS images. We manually segmented BML volumes, testing repeatability of BML volumes in knees remeasured. Using the standard deviation of the difference between repeated measurements to calculate Bland–Altman Limits of Agreement, we determined how much BML volume change represented a change greater than due to chance.
Results
Fifty-two patients had BMLs at baseline. Test–retest reliability for BML volume was high (ICC 0.89, 95% CI 0.80–0.97). All knees showed at least some change in BML volume by 6 and 12 weeks. On the axial view at 6 weeks, 20/49 (40.8%) knees showed BML volume changes greater than the limits of agreement with similar results at 12 weeks. BML changes were evenly divided among knees with enlarging and shrinking BMLs. 63.3% of the knees had more than 50% change in BML volume at either 6 or 12 weeks on the axial view and 48.7% on the sagittal view
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Osteoarthritis and Cartilage | ||||
Publisher: | Elsevier Science BV | ||||
ISSN: | 1063-4584 | ||||
Official Date: | 2012 | ||||
Dates: |
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Volume: | 20 | ||||
Number: | 12 | ||||
Page Range: | pp. 1514-1518 | ||||
DOI: | 10.1016/j.joca.2012.08.020 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) |
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