Abstract：
OBJECTIVE:To confirm altered perfusion within tibial bone marrow lesions (BMLs) and improve our understanding on the relationship between BMLs and pain in knee osteoarthritis (OA). METHODS:Participants with moderate to severe knee OA were recruited and pain was assessed using the pain subscale of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Subchondral tibial BMLs were identified and graded on magnetic resonance imaging (MRI) proton density-weighted (PDW) fat suppressed images. A pharmacokinetic model was used to analyze perfusion parameters on dynamic contrast enhanced (DCE) MRI which represent transfer rates in and out of the BMLs. The relation between perfusion and pain was evaluated using multivariable linear regression after adjustment for BML grade, age, gender and body mass index (BMI). RESULTS:There were 37 participants (mean age 64.9 years, range 46-86) with radiographic Kellgren and Lawrence grades of 3 and 4 in the study knee; 75.6% had BMLs that were classified grades 1 and 2. The mean WOMAC pain score was 10.3 (0-20 scale). There was a significant correlation between BML K(el) (rate of contrast elimination) and BML grade (P = 0.001 univariate, P = 0.002 multivariate analyses), although we did not demonstrate any significant multivariate association between BML perfusion and pain. We also found an inverse relationship between pain at sleep and BML grade (P < 0.05). CONCLUSIONS:The absence of any significant association between bone perfusion and pain implies that the relationship of tibial BMLs to pain in OA is still incompletely understood. BMLs are just one component of the whole knee joint and are formed from various causes, all of which interact and collectively contribute to the genesis of pain in OA.
journal_name
Osteoarthritis Cartilagejournal_title
Osteoarthritis and cartilageauthors
Seah S,Wheaton D,Li L,Dyke JP,Talmo C,Harvey WF,Hunter DJdoi
10.1016/j.joca.2012.08.025subject
Has Abstractpub_date
2012-12-01 00:00:00pages
1527-33issue
12eissn
1063-4584issn
1522-9653pii
S1063-4584(12)00948-Xjournal_volume
20pub_type
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pub_type： 杂志文章,meta分析,评审
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更新日期：2015-01-01 00:00:00
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journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
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journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
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journal_title：Osteoarthritis and cartilage
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期：1993-10-01 00:00:00
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journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
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更新日期：2016-02-01 00:00:00
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journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
doi：10.1016/j.joca.2006.12.005
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journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
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更新日期：2003-03-01 00:00:00
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更新日期：2001-11-01 00:00:00
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journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
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journal_title：Osteoarthritis and cartilage
pub_type： 杂志文章
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更新日期：2009-01-01 00:00:00
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journal_title：Osteoarthritis and cartilage
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