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Multicenter Study
. 2009 Sep;68(9):1461-5.
doi: 10.1136/ard.2008.096834. Epub 2008 Oct 1.

Change in MRI-detected subchondral bone marrow lesions is associated with cartilage loss: the MOST Study. A longitudinal multicentre study of knee osteoarthritis

F W Roemer  1 , A Guermazi, M K Javaid, J A Lynch, J Niu, Y Zhang, D T Felson, C E Lewis, J Torner, M C Nevitt; MOST Study investigators
Affiliations
Multicenter Study

Change in MRI-detected subchondral bone marrow lesions is associated with cartilage loss: the MOST Study. A longitudinal multicentre study of knee osteoarthritis

F W Roemer et al. Ann Rheum Dis. 2009 Sep.

Abstract

Objectives: To describe the natural history of subchondral bone marrow lesions (BMLs) in a sample of subjects with knee osteoarthritis (OA) or at risk of developing it. Additionally, to examine the association of change in BMLs from baseline to 30-month follow-up with the risk of cartilage loss in the same subregion at follow-up.

Methods: 1.0 T MRI was performed using proton density-weighted, fat-suppressed sequences. BML size and cartilage status were scored in the same subregions according to the WORMS system. Subregions were categorised based on comparison of baseline and follow-up BML status. A logistic regression model was used to assess the association of change in BML status with cartilage loss over 30 months using stable BMLs as the reference group.

Results: 395 knees were included. 66% of prevalent BMLs changed in size; 50% showed either regression or resolution at follow-up. The adjusted odds ratios (95% confidence intervals) of cartilage loss in the same subregion at follow-up for the different groups were 1.2 (0.5 to 1.6) for regressing BMLs, 0.9 (0.5 to 1.6) for resolving BMLs, 2.8 (1.5 to 5.2) for progressing BMLs, 0.2 (0.1 to 0.3) for subregions with no BMLs at baseline and follow-up and 3.5 (2.1 to 5.9) for newly developing BMLs. BML size at baseline was associated with risk of subsequent cartilage loss.

Conclusions: The majority of pre-existing BMLs decreased in size at follow-up. Absence of BMLs was associated with a decreased risk of cartilage loss, while progressing and new BMLs showed a high risk of cartilage loss in the same subregion.

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Figures

Figure 1
Figure 1
Example of resolving bone marrow lesion (BML). (A) Coronal STIR image. Prevalent large BML in posterior medial tibial plateau (arrowheads). (B) Coronal STIR image. Note complete resolution of preexisting BMLs. No BML is observed at follow-up.
Figure 2
Figure 2
Example of changing bone marrow lesions (BMLs) from baseline to 30-month follow-up in the same knee. (A) Coronal STIR image. Prevalent BML anterior femur (arrowheads) and small BML medial tibia (arrows) at baseline examination. (B) Coronal STIR image. Resolution of anterior BML, large new BML medial femur (arrowheads) and volume-progressive BML medial tibia (white arrows) in the same knee. Note concomitant cartilage loss medial compartment (small black arrows) and progressive medial meniscal subluxation (small grey arrows).
See this image and copyright information in PMC

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