ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 208

Correlates of Knee Bone Marrow Lesions in Younger Adults

Benny Samuel Eathakkattu Antony1, Graeme Jones2, Alison Venn3, Lyn March4, Flavia Cicutinni5, Andrew Halliday6, Leigh Blizzard7, Marita Cross8, Terry Dwyer9 and Changhai Ding2, 1Musculoskeletal, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia, 2Musculoskeletal Unit, Menzies Research Institute Tasmania, University of Tasmania, Hobart,7000, Australia, 3Epidemiology, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia, 4Rheumatology, Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia, 5Department of Epidemiology and Preventive Medicine, Monash University, Monash University, Melbourne, Australia, Melbourne, Australia, 6Radiology, Royal Hobart Hospital, Australia, Hobart, Australia, 7Statistics, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia, 8University of Sydney Institute of Bone and Joint Research, Royal North Shore Hospital, Sydney, Australia, 9Director, Murdoch Children's Research Institute, Melbourne, Australia

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Title: Osteoarthritis - Clinical Aspects: Imaging and Biomechanics

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Bone marrow lesions (BMLs) of the knee joint are a key player in osteoarthritis of the knee. However, little is known of their determinants, especially in young adults. The aim of this study was to examine the structural and functional correlates of BMLs in younger adults including physical activity and to determine whether bone mass, cholesterol and hormones measured 5 years prior are associated with current BMLs.

Methods:

Subjects broadly representative of the Australian population (n=330, aged 31-41 years, female 48.7%) were selected from the Childhood Determinants of Adult Health study. They underwent T1 and T2-weighted fat- suppressed magnetic resonance imaging in their knee. BMLs, cartilage defects, meniscal tears and cartilage volume were measured. Knee pain was assessed by self-administered Western Ontario and McMasters osteoarthritis index (WOMAC) questionnaire. Physical activity was measured by IPAQ questionnaires at the time of MRI. Heel bone mass, cholesterol and hormone levels (in females) were assessed 5 years prior.

Results:

The prevalence of any BMLs in the knee joint was 17%. Cross-sectionally, any BML in the knee was associated with age (PR: 1.09, 95% CI: 1.00, 1.19), previous knee injury (medial tibiofemoral BMLs PR: 2.20, 95% CI: 1.03, 4.71) and total WOMAC knee pain (PR: 1.05, 95% CI: 1.02, 1.09). BMLs were associated with other structural abnormalities such as total knee cartilage defects (PR: 2.65, 95% CI: 1.47, 4.80) and total meniscal tears (PR: 1.70, 95% CI: 0.99, 2.94).


High Density Lipoprotein (HDL) cholesterol measured 5 years prior was negatively associated with any BML (PR: 0.36, 95% CI: 0.15, 0.87). Testosterone measured 5 years prior in females (PR: 0.99, 95% CI: 0.99, 1.00) and speed of sound in both sexes (bone mass, PR: 0.98, 95% CI: 0.97, 0.99) were negatively associated with femoral BMLs. Moderate physical activity was protective (PR: 0.93, 95% CI: 0.87, 0.99) while vigorous activity showed a deleterious trend (PR: 1.01, 95% CI: 1.00, 1.02) with BMLs as we reported in older and middle aged adults. All these models were adjusted for age, gender, BMI, duration of follow-up and injury. 

Conclusion:

BMLs in young adults are associated with increased knee symptoms, a history of injury and other knee structural lesions. Moderate physical activity (not vigorous) may be protective with BML. A higher bone mass and HDL cholesterol in both sexes and testosterone in women may be protective with the development of BMLs in young adults.

Disclosure:

B. S. Eathakkattu Antony,
None;

G. Jones,
None;

A. Venn,
None;

L. March,
None;

F. Cicutinni,
None;

A. Halliday,
None;

L. Blizzard,
None;

M. Cross,
None;

T. Dwyer,
None;

C. Ding,
None.

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