MRI DETERMINED BONE MARROW EDEMA IN OSTEOARTHRITIS OF THE KNEE

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。尽管骨关节炎（OA）非常普遍，包括关节软骨、软骨下骨和滑膜受损，但疼痛作为一种症状导致了许多残疾，需要治疗和医疗保健费用。对于骨关节炎疼痛模式与关节组织之间的关系，人们的理解非常有限，特别是因为软骨没有感觉疼痛所需的神经末梢。然而，更好地了解与关节结构相关的导致疼痛性骨关节炎发展和持续的过程，可能会增加干预的选择。该应用有助于一系列研究，以确定OA疼痛是否与骨髓水肿（BME）相关，仅通过磁共振成像（MRI）观察到。据推测，这种“水肿”或液体积聚增加了关节内骨骼的压力，并激活了骨骼中的疼痛感受器。进一步提出，BME部分来自于膝关节上不均匀的负重，很可能是由肥胖引发或延续的。目前，BME的定性评估是基于对病变大小的3个级别的确定。我们建议开发一种定量方法来测量BME，并描述该方法与MRI的可重复性。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Though osteoarthritis (OA) is highly prevalent and includes compromised articular cartilage, subchondral bone, and synovium, pain as a symptom drives much of the disability, requirement for therapy and health care costs. There is a very limited understanding of how OA pain patterns are related to tissue in the joint, particularly since cartilage does not have nerve endings that are required to feel pain. However, a better understanding of the processes leading to the development and perpetuation of painful OA, in relation to joint structures, is likely to extend the number of options for intervention. This application contributes to a series of studies to determine if pain in OA is associated with bone marrow edema (BME), observable only with magnetic resonance imaging (MRI). It is proposed that this "edema" or fluid accumulation increases the pressure within bone in joints and activates pain receptors in the bone. It is further proposed that BME comes, in part, from mal-distributed weight-bearing forces on the knee and is most likely initiated or perpetuated by obesity. Currently, BME is evaluated qualitatively based on a 3-level determination of the size of a lesion. We propose to develop a quantitative approach to measure BME and describe the reproducibility of that approach with MRI.