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• W2936433611 abstract "Purpose: Bone marrow lesions (BMLs), ill-defined regions of hyperintense signal on magnetic resonance imaging (MRI), typically occur within the subchondral bone. A proportion may, however, occur at the ligament attachments at the central region of the knee and a proportion may contain cyst-like components. Data from observational studies suggest that subchondral BMLs are associated with the occurrence of knee pain. There are, however, few data concerning the association between knee symptoms and the volume of ligament-based BMLs and also the volume of BMLs with cyst-like components.Aim: The aims of this analysis were to determine whether i) BML location (subchondral / ligament-based) and ii) presence or absence of cyst-like components influences the occurrence of symptoms in men and women with symptomatic knee OA. We looked also at the association between synovial tissue volume (STV) and symptoms. Methods: Data were collected from a sub-sample of subjects who participated in the UK VIDEO study; a randomised, placebo-controlled trial of vitamin D therapy in men and women with symptomatic knee OA. Participants recruited to the Southampton (UK) arm of the trial received contrast-enhanced (CE) MRI of the index knee at both the baseline visit and at annual follow-ups. BML volume (mm3) was assessed by manual segmentation using T1-weighted fat-suppressed CE MRI. BMLs were categorised by location, subchondral or ligament-based, and by the presence/absence of internal regions of well-defined, rounded high signal on CE MRI which we refer to as cyst-like components. BMLs were included for assessment if appearing on ≥2 adjacent slices. As part of assessment, the volume of any cyst-like component was also segmented from those subchondral BMLs with cyst-like components. Further, total volume measurements, i.e. the sum of BMLs with and without cyst-like components, were calculated for each region. STV was also segmented across the whole knee joint using a semi-automated approach. As part of the trial, WOMAC outcomes were assessed at baseline and annually. We used fixed-effects linear panel regression, adjusting for repeat observations, to determine the impact of BML volume and STV on symptoms. Results: 50 subjects who had a baseline CE-MRI and at least one other performed over the first 2 years of follow-up were included. Mean age of the study subjects was 63.3 (SD ± 6.5) years and 74% were female. There was no association between total subchondral BML volume and knee pain (b = 0.3 score units , 95% CI -0.3 to 1.0) and total ligament-based BML volume and pain (b = 1.9, 95% CI -1.5 to 5.3). We did, however, observe an association between the volume of subchondral BMLs with cyst-like components and knee pain (b = 1.3, 95% CI 0.1 to 2.4); with the volume of the cyst-like component itself also associated with pain (b = 0.06, 95% CI 0.02 to 0.1). A significant association was observed between STV and pain(b = 2.2, 95% CI 0.6 to 3.7), function (b = 2.1, 95% CI 0.3 to 3.8) and total score (b = 2.0, 95% CI 0.5 to 3.5). Conclusions: The volume of subchondral BMLs with cyst-like components on CE-MRI was associated with knee pain with the volume of the cyst-like component also associated with pain. In agreement with previous studies, STV was associated with knee symptoms. BML location did not appear to influence the occurrence of knee symptoms in symptomatic knee OA subjects." @default.
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• W2936433611 date "2019-04-01" @default.
• W2936433611 modified "2023-09-26" @default.
• W2936433611 title "Bone marrow lesion subtype and symptoms in knee osteoarthritis" @default.
• W2936433611 doi "https://doi.org/10.1016/j.joca.2019.02.771" @default.
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