Clinical and Pathophysiologic Significance of MRI Identified Bone Marrow Lesions Associated with Knee Osteoarthritis

Abstract

Knee osteoarthritis (OA) affects the joint beyond just the articular cartilage. Specifically, magnetic resonance imagingidentified<br />bone marrow lesions (BML) in the subchondral bone have both clinical and pathophysiological significance.<br />Compared to joint space narrowing on traditional radiographs, the presence of BMLs has been better correlated with<br />severity of clinical symptoms as well as clinical deterioration. Presence of a BML increases the likelihood for progression<br />to a total knee arthroplasty by up to nine fold. Histochemical analysis of BMLs has shown increased levels of tumor<br />necrosis factor-alpha, matrix metalloproteinases and substance P, thought to stimulate pain receptors in osteoarthritis.