Bone marrow lesions can predict joint disease

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Bone marrow lesions can predict joint disease

Osteoarthritis (OA) is the most common type of arthritis in the UK which can cause the joints to become painful and stiff. A new study has discovered that bone marrow lesions can help to identify how fast osteoarthritis is progressing.

Researchers from the University of Southampton discovered that lesions can be visible through magnetic resonance imaging (MRI) scans and can determine that a person is likely to develop a degenerative joint disease such as osteoarthritis or not.

This chronic condition can affect any joint in human body but the weight-bearing joints like back, hips, knees as well as the hands are mostly attacked by the osteoarthritis. The SEKOIA study, a major international osteoarthritis disease-modifying trial carried out MRI scanning on the knees of a group of 176 people, including both men and women over 50 years of age. They were followed up for an average of 3 years with repeated knee x-rays. Individuals with bone marrow lesions on their MRI scan were found to have osteoarthritis that progressed more rapidly than those that did not.

On an average, the space within the joint is lost at a rate of 0.15mm/year. These findings showed that individuals with BMLs experienced a loss of space within the joint at a rate of 0.10mm/year faster than those with no bone marrow lesions. This may lead to the need for joint replacement or other intervention at earlier.

Bone marrow lesions associated with OA appear as areas of bone located beneath the cartilage with evidence of bone marrow edema, fibrosis, and necrosis. This study highlights a potential early indicator of rapidly progressing knee OA that may help guide early treatment and intervention. It also underscores the need for further study into the mechanisms by which bone marrow lesions are affecting the rates of progression of OA and the possibility for new therapeutic interventions.

"Osteoarthritis causes a significant burden to individuals and the healthcare system as a whole. If we can identify those people who may experience a rapid progression of the disease, this may be of benefit to both physicians and patients. The next step would be to explore the mechanisms through which bone marrow lesions might influence the progression of osteoarthritis and whether this could lead to a novel treatment," said Mark Edwards, Clinical Lecturer in Rheumatology at the MRC Lifecourse Epidemiology Unit, University of Southampton, in UK and the lead author of the study.

Professor Cyrus Cooper, Professor of Rheumatology and Director of the MRC Lifecourse Epidemiology Unit, University of Southampton added, "This study points to the utility of data derived from large randomised controlled trials in deriving predictive models which will facilitate a stratified approach to therapy in knee osteoarthritis, the commonest cause of arthritis worldwide."

University of Southampton

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