A new study from the
Medical Research Council Lifecourse Epidemiology Unit, University of
Southampton, shows lesions, which can best be seen on MRI scans, could
help identify individuals who are more likely to suffer from more rapidly
progressing osteoarthritis.
Osteoarthritis is the
most common type of arthritis in
the UK and can cause the joints to become painful and stiff. Almost any joint
can be affected, but it most often causes problems in the knees, hips, and
small joints of the hands. It can progress at varying speeds.
The SEKOIA study, a major international osteoarthritis
disease-modifying trial, carried out MRI scanning 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 to examine the
effect on disease progression.
Individuals with bone
marrow lesions (BMLs) on their MRI scan were found to have
osteoarthritis that progressed more rapidly than those that did not. On
average, the space within the joint is lost at a rate of 0.15mm per year
however the Southampton study shows that, overall, individuals with BMLs had a
loss rate that was 0.10mm per year faster than those without BMLs. This may
lead to earlier need for joint replacement or other intervention.
BMLs 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. The Southampton researchers believe that therapies to
target these abnormalities may slow the progression of this disabling joint
disease, but further work is required to examine this.
Dr Mark Edwards,
Clinical Lecturer in Rheumatology at the MRC Lifecourse Epidemiology Unit,
University of Southampton, led the study which has been published in The Journal of Rheumatology.
He comments: "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."
Professor Cyrus Cooper, Professor of
Rheumatology and Director of the MRC Lifecourse Epidemiology Unit, University
of Southampton adds: "This study points to the utility of data derived
from large randomised controlled trials in deriving predictive models which
will facilitate a stratified approach to therapy in knee osteoarthritis, the
commonest cause of arthritis worldwide."
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