tailieunhanh - Báo cáo y học: "Natural history and clinical significance of MRI-detected bone marrow lesions at the knee: a prospective study in community dwelling older adults"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Natural history and clinical significance of MRI-detected bone marrow lesions at the knee: a prospective study in community dwelling older adults. | Dore et al. Arthritis Research Therapy 2010 12 R223 http content 12 6 R223 RESEARCH ARTICLE Open Access Natural history and clinical significance of MRI-detected bone marrow lesions at the knee a prospective study in community dwelling older adults 1 1 1 f 71 -3 2 Dawn Dore Stephen Quinn Changhai Ding Tania Winzenberg Guangju Zhai Flavia Cicuttini Graeme Jones1 Abstract Introduction There are conflicting data on the natural history and clinical significance of bone marrow lesions BMLs . The aims of this study were to describe the natural history of MRI-detected BMLs at the knee using a quantitative measure and examine the association of BMLs with pain function and stiffness scores and total knee replacement TKR surgery. Methods A total of 395 older males and females were randomly selected from the general population mean age 63 years range 52 to 79 and measured at baseline and approximately years later. BMLs were determined using T2-weighted fat saturation MRI by measuring the maximum area of the lesion. Reproducibility was excellent intraclass correlation coefficient ICC . Pain function and stiffness were assessed by Western Ontario and McMaster Universities Osteoarthritis WOMAC scores. X-ray was used to assess radiographic osteoarthritis ROA at baseline. Results At baseline 43 n 168 395 had a BML. Of these 25 decreased in size and 24 increased. Of the remaining sample n 227 7 developed a new BML. In a multivariable model a change in BML size was associated with a change in pain and function scores b to per 1 SD increase all P only in those participants without ROA. Lastly baseline BML severity predicted TKR surgery odds ratio OR unit P . Conclusions In a population based sample BMLs assessed by measuring maximal area were not static with similar proportions both worsening and improving. A change in BML size was associated with changes in pain in those without established ROA. This finding suggests that