The association of bone marrow lesions with pain in knee osteoarthritis
The association of bone marrow lesions with pain in knee osteoarthritis
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DOI：
10.7326/0003-4819-134-7-200104030-00007
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发表时间：
2001-04-03
影响因子：
39.2
通讯作者：
Gale, DR
中科院分区：
文献类型：
--
作者：
Felson, DT;Chaisson, CE;Gale, DR
背景：骨关节炎疼痛的原因尚不清楚。骨有疼痛纤维，骨髓病变，这被认为是代表水肿，已注意到在osteoarthritis.Objective：To determine whether bone marrow lesions on magnetic resonance imaging（MRI）are associated with pain in knee osteoarthritis.Design：横断面观察性研究. Set：Veterans Affairs Medical Center.Patients：401例（平均年龄66.8岁）膝关节骨关节炎患者，来自退伍军人管理局医疗保健系统诊所和社区。这些人中，351膝关节疼痛和50没有膝关节疼痛。测量：膝关节X线片和MRI的一个膝盖进行了所有参与者。那些膝盖疼痛的人量化了他们疼痛的严重程度。在MRI上，冠状面T-2加权脂肪饱和图像用于对骨髓病变的大小进行评分，每个膝关节被描述为有任何病变或任何大病变，比较有和没有膝关节疼痛的人中病变和大病变的患病率;在膝关节疼痛的参与者中，病变的存在与疼痛的严重程度相关。351例膝关节疼痛患者中有272例（77.5%）发现骨髓病变，而50例无膝关节疼痛患者中有15例（30%）发现骨髓病变（P < 0.001）。大的病变几乎只出现在膝关节疼痛的患者中（35.9%对2%; P < 0.001）。在调整了放射学疾病的严重程度、积液、年龄和性别后，病变和大病变仍然与膝关节疼痛的发生相关。在膝关节疼痛的人，骨髓病变与疼痛severity.Conclusions：骨髓病变的MRI是强烈相关的存在疼痛的膝关节骨关节炎。
Background: The cause of pain in osteoarthritis is unknown. Bone has pain fibers, and marrow lesions, which are thought to represent edema, have been noted in osteoarthritis.Objective: To determine whether bone marrow lesions on magnetic resonance imaging (MRI) are associated with pain in knee osteoarthritis.Design: Cross-sectional observational study.Setting: Veterans Affairs Medical Center.Patients: 401 persons (mean age, 66.8 years) with knee osteoarthritis on radiography who were drawn from clinics in the Veterans Administration health care system and from the community. Of these persons, 351 had knee pain and 50 had no knee pain.Measurements: Knee radiography and MRI of one knee were performed in all participants. Those with knee pain quantified the severity of their pain. On MRI, coronal T-2-weighted fat-saturated images were used to score the size of bone marrow lesions, and each knee was characterized as having any lesion or any large lesion, The prevalence of lesions acid large lesions in persons with and without knee pain was compared; in participants with knee pain, the presence of lesions was correlated with severity of pain.Results: Bone marrow lesions were found in 272 of 351 (77.5%) persons with painful knees compared with 15 of 50 (30%) persons with no knee pain (P < 0.001). Large lesions were present almost exclusively in persons with knee pain (35.9% vs. 2%; P < 0.001). After adjustment for severity of radiographic disease, effusion, age, and sex, lesions and large lesions remained associated with the occurrence of knee pain. Among persons with knee pain, bone marrow lesions were not associated with pain severity.Conclusions: Bone marrow lesions on MRI are strongly associated with the presence of pain in knee osteoarthritis.