Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Radiographic Severity of Knee Osteoarthritis Predicts Quantitative Bone Marrow Lesions on MRI.

Krasnokutsky4,  Svetlana, Regatte2,  Ravinder, Bencardino2,  Jenny, Rybak2,  Leon, Belitskaya-Levy2,  Ilana, Samuels1,  Jonathan, Attur3,  Mukundan

New York University Hospital for Joint Disease, New York, NY
NYU Langone Medical Center
NYU Langone Medical Center, NYU Hospital for Joint Diseases
NYU Langone Medical Center, NYU Hospital for Joint Diseases, New York, NY


To evaluate the relationship of quantitative assessment of Bone Marrow Lesions (BML) with knee OA severity by radiographic findings.


58 OA patients (mean age 62±10, mean BMI 27±3, 59% female) underwent standardized nonfluoroscopic fixed-flexion knee radiographs. Two radiologists read the X-rays for KL grade, joint space width (JSW), and, using the OARSI atlas, joint space narrowing (JSN) and osteophytes; inter-reader agreement was assessed using Kappas and concordance correlation coefficients. Linear and logistic regression analysis was performed to assess associations while controlling the effects of age, sex and BMI. 3T-MRI included sagittal T2-weighted fat saturated spin-echo images (TR/TE=4000ms/75ms, FOV=15cm, matrix=256×128, slice thickness=3.0mm, receiver bandwidth 130Hz/pixel) and in/out of phase of FLASH images. Compartment-wise (medial tibial, lateral tibial, medial femur, lateral femur) BML volumes were quantified with T2-weighted fat saturated images and in/out of phase images respectively. BML volumes were dichotomized for statistical analysis.


KL score was a significant predictor of total BML volume (OR = 8.41, p = 0.0235). Medial tibial JSW, OARSI medial JSN, and medial tibial plateau osteophytes approached significance as predictors of BML volume at the medial tibia (OR = 0.71, p = 0.0551; OR = 2.16, p = 0.0597; and OR = 2.68, p = 0.0875, respectively). OARSI lateral JSN was a significant predictor of BML volume at the lateral tibia (OR = 3.62, p = 0.0169). Lateral tibial plateau osteophytes were predictors of total BML volume (OR = 4.58, p = 0.0299) and of BML volume at the lateral tibia (OR = 2.31, p = 0.0685). Lateral femoral condyle osteophytes approached significance as a predictor for BML at the lateral femur (OR = 2.25, p = 0.0651). Furthermore, quantitative BML volume strongly correlated with total quantitative synovial volume measured on MRI (b= 0.22, p = 0.0003).


Our data indicate that BML volume on MRI is a characteristic feature of progressive stages of OA, which not only correlates with JSN and osteophytes, but does so in a compartment-specific way. The data suggest that the altered mechanical forces that promote compartmental disease in OA lead to BML, JSN and osteophyte formation. Whether BML further contribute to cartilage loss, and are therefore targets of therapeutic intervention, remains to be determined.

This study is funded by NIAMS (R01-AR052873)

To cite this abstract, please use the following information:
Krasnokutsky, Svetlana, Regatte, Ravinder, Bencardino, Jenny, Rybak, Leon, Belitskaya-Levy, Ilana, Samuels, Jonathan, et al; Radiographic Severity of Knee Osteoarthritis Predicts Quantitative Bone Marrow Lesions on MRI. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :137
DOI: 10.1002/art.27906

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