University Of Tasmania
2014 Yi Chao The clinical significance, natural history and predictors of bone marrow lesion change over eight years.pdf (250.69 kB)
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The clinical significance, natural history and predictors of bone marrow lesion change over eight years

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posted on 2023-05-18, 02:37 authored by Foong, YC, Khan, HI, Christopher BlizzardChristopher Blizzard, Chang-Hai DingChang-Hai Ding, Cicuttini, F, Graeme JonesGraeme Jones, Dawn AitkenDawn Aitken
Introduction: There is increasing evidence to suggest that bone marrow lesions (BMLs) play a key role in the pathogenesis of osteoarthritis (OA). However, there is a lack of long term data. The aim of this study was to describe the natural history of knee BMLs, their association with knee pain and examine predictors of BML change over eight years.Methods: A total of 198 subjects (109 adult offspring of subjects who had a knee replacement and 89 community-based controls) were studied. Knee pain and BML size were assessed at two and ten year visits.Results: At the two year visit, 64% of participants (n = 127) had 229 BMLs (34% patella, 26% femoral and 40% tibial). Over eight years, 24% (55/229) increased in size, 55% (125/229) remained stable and 21% (49/229) decreased in size or resolved completely. Of the participants without BMLs at baseline, 52% (37/71) developed incident BMLs.After adjusting for confounders, eight year change in total BML size was associated with change in knee pain in offspring (β = 2.50, 95% confidence interval (CI) 0.96 to 4.05) but not controls. This association was stronger in males. Incident BMLs were associated with increase in pain (β = 3.60, 95% CI 1.14 to 6.05). Body mass index (BMI) and strenuous activity (but not radiographic osteoarthritis or smoking) were associated with an increase in BML size.Conclusion: In this midlife cohort, the proportion of BMLs increasing in size was similar to those decreasing in size with the majority remaining stable. Change in BMLs was predicted by BMI and strenuous activity. An increase in BML size or a new BML resulted in an increase in pain especially in males and those with a family history of OA. © 2014 Foong et al.; licensee BioMed Central Ltd.


Publication title

Arthritis Research & Therapy





Article number









Menzies Institute for Medical Research


Biomed Central Ltd

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Middlesex House, 34-42 Cleveland St, London, England, W1T 4Lb

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Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

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  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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