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Review
. 2025 Feb;54(2):175-191.
doi: 10.1007/s00256-024-04725-0. Epub 2024 Jun 14.

Bone marrow lesions in osteoarthritis: biomarker or treatment target? A narrative review

Liru Ge  1 , Xiaoyue Zhang  1 , Rui Zhu  1 , Guoqi Cai  2   3
Affiliations
Review

Bone marrow lesions in osteoarthritis: biomarker or treatment target? A narrative review

Liru Ge et al. Skeletal Radiol. 2025 Feb.

Abstract

Osteoarthritis (OA) is a leading cause of pain, functional impairment, and disability in older adults. However, there are no effective treatments to delay and reverse OA. Magnetic resonance imaging (MRI) can assess structural abnormalities of OA by directly visualizing damage and inflammatory reactions within the tissues and detecting abnormal signals in the subchondral bone marrow region. While some studies have shown that bone marrow lesions (BMLs) are one of the early signs of the development of OA and predict structural and symptomatic progression of OA, others claimed that BMLs are prevalent in the general population and have no role in the progression of OA. In this narrative review, we screened and summarized studies with different designs that evaluated the association of BMLs with joint symptoms and structural abnormalities of OA. We also discussed whether BMLs may serve as an imaging biomarker and a treatment target for OA based on existing clinical trials.

Keywords: Bone marrow edema; Bone marrow lesion; Magnetic resonance imaging (MRI); Osteoarthritis.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

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