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A population-based study of the association between hip bone marrow lesions, high cartilage signal, and hip and knee pain

Clinical Rheumatology volume 33, pages 369–376 (2014)Cite this article

Abstract

The objective of this study was to describe the cross-sectional and longitudinal relationship between hip bone marrow lesions (BMLs), high cartilage signal, and hip and knee pain. One hundred ninety-eight participants in the Tasmanian Older Adult Cohort Study with right hip MRI conducted at two time points, approx. 2.3 years apart, were included. Short T1 Inversion Recovery MR images were used to quantitatively measure hip BML size and determine high cartilage signal presence. Hip and knee pain were individually assessed using the Western Ontario and McMaster Universities Osteoarthritis index pain score. Fifty-five participants (28 %) had either femoral and/or acetabular BMLs. Cross-sectionally, the presence of large femoral, acetabular, or any hip BMLs was associated with higher odds of hip pain (OR = 4.42, 95% CI = 1.37–19.7; OR = 5.23, 95% CI = 1.17–22.9; OR = 4.43, 95% CI = 1.46–13.2, respectively). High cartilage signal was strongly associated with hip BMLs (OR = 6.45, 95% CI = 3.37–12.6), but not with pain. Longitudinally, incident acetabular (Mean diff = +5.90, 95% CI = +3.78 to +8.15) and femoral BMLs (Mean diff = +1.18, 95% CI = 0.23–1.94) were associated with worsening hip pain, while resolving femoral BMLs were associated with a decrease in knee pain (Mean diff = −3.18, 95% CI = −5.99 to −0.50). The evidence is consistent for hip, but not knee pain, and strongly suggests that large hip BMLs are associated with hip pain. Furthermore, high cartilage signal is asymptomatic, but strongly associated with hip BMLs. These findings suggest that hip BMLs play an important role in hip osteoarthritis.

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Acknowledgments

Special thanks go to the participants of the TASOAC Study. We thank Catrina Boon and Pip Boon for their contribution in collecting the data for this study. This work was supported by the National Health and Medical Research Council of Australia, Tasmanian Community Fund, Masonic Centenary Medical Research Foundation, Royal Hobart Hospital Research Foundation, and the Arthritis Foundation of Australia.

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Affiliations

  1. Menzies Research Institute of Tasmania, Musculoskeletal Unit, University Of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia

    Harbeer Ahedi, Dawn Aitken, Leigh Blizzard & Graeme Jones

  2. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, 3004, Australia

    Flavia Cicuttini

Authors
  1. Harbeer Ahedi
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  2. Dawn Aitken
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  3. Leigh Blizzard
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  4. Flavia Cicuttini
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  5. Graeme Jones
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Correspondence to Harbeer Ahedi.

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Ahedi, H., Aitken, D., Blizzard, L. et al. A population-based study of the association between hip bone marrow lesions, high cartilage signal, and hip and knee pain. Clin Rheumatol 33, 369–376 (2014). https://doi.org/10.1007/s10067-013-2394-0

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  • DOI: https://doi.org/10.1007/s10067-013-2394-0

Keywords

  • Bone marrow lesions (BMLs)
  • Hip pain
  • Knee pain
  • Magnetic resonance imaging
  • Osteoarthritis
  • Population-based study