Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis
Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis
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DOI：
10.1016/s1063-4584(03)00080-3
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发表时间：
2003-06-01
影响因子：
7
通讯作者：
Welch, G
中科院分区：
文献类型：
--
作者：
Sowers, MF;Hayes, C;Welch, G
目的：评估是否存在软骨下骨髓异常（骨髓水肿（BME））和软骨缺损，通过磁共振成像（MRI）确定，将解释疼痛性膝关节骨关节炎（OAK）与无痛性OAK或疼痛无OAK之间的差异。从密歇根州东南部骨关节炎队列中招募了四组年龄在35-55岁之间的女性（每组30名）（第1组：疼痛OAK;第2组：无痛OAK;第3组：无OAK的膝关节疼痛;第4组：无OAK或膝关节疼痛）。OAK定义为Kelling-Lawrence评分≥ 2，而疼痛基于自我报告。结果：56%的膝关节发现BME病变。无痛OAK组发生BME病变的可能性是疼痛但无OAK组的4倍（95% CI = 1.7，8.7）。疼痛OAK组中>1 cm的BME病变比所有其他组更常见（OR = 5.0; 95% CI =11.4，10.5）。虽然无痛OAK组和疼痛OAK组的BME病变频率相似，但疼痛OAK组的病变更多，>1 cm。约75%的膝关节有一些软骨缺损的证据，其中35%为全层缺损。全层软骨缺损经常发生在疼痛的OAK。三分之一的膝关节全层缺损和47%的膝关节软骨缺损累及骨的BME >1 cm。影像学OA、全层关节软骨缺损、邻近软骨下皮质骨缺损的女性患疼痛性OAK的可能性显著高于其他组（OR = 3.2，95%CI =11.3，7.6）。结论：MRI上软骨下BME的发现不能令人满意地解释膝关节疼痛的存在或不存在。然而，患有BME和全层关节软骨缺损并伴有邻近软骨下皮质骨缺损的女性患疼痛性OAK的可能性明显高于无痛性OAK。(C)2003年国际骨关节炎研究学会。由爱思唯尔科技有限公司出版。保留所有权利。
Objective: To assess whether the presence of subchondral bone marrow abnormalities (bone marrow edema (BME)) and cartilage defects, determined by magnetic resonance imaging (MRI), would explain the difference between painful osteoarthritis of the knee (OAK) compared with painless OAK or pain without OAK.Method. Four groups of women (30 per group), aged 35-55 years, were recruited from the southeast Michigan Osteoarthritis cohort (group 1: painful OAK; group 2: painless OAK; group 3: knee pain without OAK; and group 4: no OAK or knee pain). OAK was defined by a Kellgren-Lawrence score of 2 or greater, while pain was based on self-report. BME and cartilage defects were identified from MRI.Results: BME lesions were identified in 56% of all knees. BME lesions were four times (95% CI = 1.7, 8.7) more likely to occur in the painless OAK group as compared with the group with pain, but no OAK. BME lesions >1 cm were more frequent (OR = 5.0; 95% CI =11.4, 10.5) in the painful OAK group than all other groups. While the frequency of BME lesions was similar in the painless OAK and painful OAK groups, there were more lesions, >1 cm, in the painful OAK group.About 75% of all knees had evidence of some cartilage defect, of which 35% were full-thickness defects. Full-thickness cartilage defects occurred frequently in painful OAK. One-third of knees with full-thickness defects and 47% of knees with cartilage defects involving bone had BME >1 cm. Women with radiographic OA, full-thickness articular cartilage defects, and adjacent subchondral cortical bone defects were significantly more likely to have painful OAK than other groups (OR = 3.2; 95% CI=11.3, 7.6).Conclusion: The finding on MRI of subchondral BME cannot satisfactorily explain the presence or absence of knee pain. However, women with BME and full-thickness articular cartilage defects accompanied by adjacent subchondral cortical bone defects were significantly more likely to have painful OAK than painless OAK. (C) 2003 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved.