Osteoarthritis can progress at varying speeds, and early diagnosis gives patients the best chance of effective treatment. According to a recent study, bone marrow lesions could help identify people who are more likely to suffer from a rapidly progressing form of the joint disease.
The Medical Research Council Lifecourse Epidemiology Unit at the University of Southampton found that individuals with bone marrow lesions on their MRI scan had osteoarthritis that progressed more rapidly than those that did not.
The research was based on the the SEKOIA study, a major international osteoarthritis disease-modifying trial, which carried out MRI scans 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.
Individuals with abnormalities on their MRI scans at the first appointment were compared to those without abnormalities to examine the effect on disease progression.
On average, the space within the joint is lost at a rate of 0.15mm per year, but the study revealed that individuals with bone marrow lesions had a loss rate that was 0.10mm per year faster. This may lead to earlier need for joint replacement or other intervention, the university pointed out.
Bone marrow lesions 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. It´s possible that therapies specifically targeting these abnormalities could slow the progression of the disease.
Study leader Dr. Mark Edwards, clinical lecturer in Rheumatology at the MRC Lifecourse Epidemiology Unit, said:
“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.”
The findings of the study have been published in the Journal of Rheumatology.