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Title: Bone marrow lesions can be subtyped into groups with different clinical outcomes using two magnetic resonance imaging (MRI) sequences.
Epworth Authors: O'Sullivan, Richard
Other Authors: Maulana, R.
Liu, B.
Findlay, D.
Wluka, Anita
Cicuttini, Flavia
Giles, Graham
Teichtahl, Andrew
Wang, Yuanyuan
Keywords: BMI
Body Mass Index
MRI Sequencing
Bone Marrow Lesion
Magnetic Resonance Imaging
Bone Marrow
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Epworth Medical Imaging, Victoria, Australia
Issue Date: Sep-2015
Publisher: Springer
Citation: Arthritis Res Ther. 2015 Sep 27;17:270
Abstract: 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.
DOI: 10.1186/s13075-015-0780-5
PubMed URL:
ISSN: 1478-6362
Journal Title: Arthritis Research & Therapy
Type: Journal Article
Affiliated Organisations: University of Adelaide, Royal Adelaide Hospital, Adelaide, Australia
Monash University, Victoria, Australia
Alfred Hospital, Melbourne, Australia
Type of Clinical Study or Trial: Prospective Cohort Study
Appears in Collections:Diagnostic Services

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