Session Title: 3S106: Osteoarthritis – Clinical I: Innovations (909–914)
Session Type: ACR Abstract Session
Session Time: 4:30PM-6:00PM
Background/Purpose: In osteoarthritis (OA) structural changes are only weakly associated with pain. The reason for this discrepancy remains unknown and the exact cause of knee pain in OA is still unclear which makes the target of treatment difficult. Bone marrow lesions (BMLs) and cysts are hallmarks of knee OA changes on MRI but studies investigating the association between BML and pain show conflicting results. Our objective was to evaluate the association between pain and perfusion in BMLs assessed on static- and dynamic contrast enhanced (DCE)-MRI in patients with knee OA in a cross-sectional setting.
Methods: MRI was performed at enrolment in the LOSEIT trial (ClinicalTrials.gov NCT02905864) studying persons with overweight/obesity and knee OA. BMLs with and without subchondral cystes were assessed across the whole knee using both DCE-MRI analysed with DYNAMIKA® (Image Analysis Group, LTD, London) and non-CE-MRI scored according to the MRI Osteoarthritis Knee Score (MOAKS) and correlated to pain using the Knee injury and Osteoarthritis Outcome Score (KOOS).
Results: Data were available from 107 participants, 64% women, 89% had radiologically verified OA (KLG 2 or 3). The participants had a mean age of 60.8 years, a mean BMI of 34.5 kg/m2, a mean KOOS pain of 63.7 (0-100 scale), and a mean BML sum score of 6.5 (0-45 scale). For BMLs containing subchondral cysts the heuristic perfusion variable Time To Peak (TTP) showed a statistically significant correlation with KOOS Pain (r=0.40; p=0.002) meaning that higher and faster perfusion leading to earlier TTP in BMLs containing subchondral cysts is correlated to more knee pain. DCE-MRI parameters in BMLs without cysts and MOAKS BML scores were not correlated to KOOS pain.
Conclusion: In this study, we found that the perfusion variable TTP from DYNAMIKA® on DCE-MRI data in BMLs containing subchondral cysts was associated with the severity of knee pain in patients with knee OA. Thus DCE-MRI has the potential to separate and study different pain phenotypes of knee OA.
To cite this abstract in AMA style:Daugaard C, Riis R, Bandak E, Nybing J, Hangaard S, Gudbergsen H, Henriksen M, Bliddal H, Boesen M. Perfusion in Bone Marrow Lesions Assessed on Dynamic Contrast-enhanced MRI and Its Association with Pain in Knee Osteoarthritis: A Cross-sectional Study [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/perfusion-in-bone-marrow-lesions-assessed-on-dynamic-contrast-enhanced-mri-and-its-association-with-pain-in-knee-osteoarthritis-a-cross-sectional-study/. Accessed July 3, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/perfusion-in-bone-marrow-lesions-assessed-on-dynamic-contrast-enhanced-mri-and-its-association-with-pain-in-knee-osteoarthritis-a-cross-sectional-study/