Lesions could identify those likely to suffer from rapidly progressing osteoarthritis, study suggests
The Medical Research Council Lifecourse Epidemiology Unit at the University of Southampton, has published a new study which shows that bone marrow lesion, which can best be seen on MRI scans, can help predict rapidly progressing joint disease.
Osteoarthritis, the most common type of arthritis in the UK, can progress at varying speeds.
The study, which was published in The Journal of Rheumatology, shows that lesions could help identify people who are more likely to suffer from more rapidly progressing osteoarthritis. The SEKOIA study, carried out MRI scanning on the knees of 176 men and women over 50 years old. They were then followed up for an average of three years with repeated knee X-rays. Those people with abnormalities on their MRI at the first appointment, were compared with those without to examine the effect on disease progression.
Those people with bone marrow lesions (BMLs) on their MRI scan, were found to have osteoarthritis that progressed more rapidly than those that did not. On average, the space within the joint is lost at a rate of 0.15mm per year, but the study showed that, overall, the people with BMLs had a loss rate that was 0.10mm per year faster than those without BMLs. This may lead to earlier need for joint replacement or other intervention.
BMLs show up on MRI as regions of bone beneath the cartilage with ill-defined high signal and represent areas of bone marrow oedema, fibrosis, and necrosis. Researchers on the study believe that therapies to target these abnormalities may slow the progression of this disabling joint disease, but further work is required to exam this.
Dr Mark Edwards, who led the study, says, “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.”
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