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The Association of Bone Marrow Lesions with Pain in Knee Osteoarthritis

David T. Felson, MD, MPH; Christine E. Chaisson, MPH; Catherine L. Hill, MD, MSc; Saara M.S. Totterman, MD; M. Elon Gale, MD; Katherine M. Skinner, PhD; Lewis Kazis, ScD; and Daniel R. Gale, MD
[+] Article and Author Information

From the Boston University Arthritis Center, Boston Medical Center, Veterans Affairs Boston Healthcare System, the Center for Health Quality, Outcomes and Economic Research, Veterans Affairs Health Services Research and Development Field Program, and Boston University School of Public Health, Boston, and Bedford Veterans Affairs Medical Center, Bedford Massachusetts; and University of Rochester Medical Center, Rochester, New York.


Acknowledgments: The authors thank Sara McLaughlin, field coordinator, and other field staff; Stephen Evans and Wei Li, programmers for this study; and Dr. Michael LaValley for advice on data analysis and interpretation. They also thank Kitty Bentzler for her considerable technical expertise in production of the manuscript. Finally, they thank the study participants for generously giving their time.

Grant Support: By Bayer Corp., grant AR20613 from the National Institutes of Health, grant SDR 91006.S from the Veterans Administration, and an Arthritis Foundation Clinical Sciences Grant.

Requests for Single Reprints: David T. Felson, MD, MPH, Boston University School of Medicine, 715 Albany Street, A203, Boston, MA 02118.

Current Author Addresses: Dr. Felson, Ms. Chaisson, and Dr. Hill: Boston University School of Medicine, 715 Albany Street, A203, Boston, MA 02118.

Dr. Totterman: Department of Radiology, University of Rochester Medical Center, 601 Elmwood Avenue, PO Box 694, Rochester, NY 14624-8648.

Drs. M.E. Gale and D. Gale: Radiology Department, Boston Veterans Affairs Medical Center, 1505 Huntington Avenue, Boston, MA 02130.

Drs. Skinner and Kazis: Health Services Research (152), Health Services Research and Development Field Program, Veterans Affairs Medical Center Bedford (Building 70), 200 Springs Road, Bedford, MA 01730.

Author Contributions: Conception and design: D.T. Felson, S.M.S. Totterman, K.M. Skinner, L. Kazis, D.R. Gale.

Analysis and interpretation of the data: D.T. Felson, C.E. Chaisson, K.M. Skinner, L. Kazis, D.R. Gale.

Drafting of the article: D.T. Felson, C.E. Chaisson, K.M. Skinner.

Critical revision of the article for important intellectual content: C.L. Hill, S.M.S. Totterman, K.M. Skinner, L. Kazis, D.R. Gale.

Final approval of the article: D.T. Felson, C.L. Hill, K.M. Skinner.

Provision of study materials or patients: C.L. Hill, M.E. Gale, K.M. Skinner, L. Kazis, D.R. Gale.

Statistical expertise: D.T. Felson.

Obtaining of funding: D.T. Felson.

Administrative, technical, or logistic support: D.T. Felson, C.E. Chaisson, M.E. Gale, D.R. Gale.

Collection and assembly of data: D.T. Felson, C.E. Chaisson, C.L. Hill, L. Kazis, D.R. Gale.


Ann Intern Med. 2001;134(7):541-549. doi:10.7326/0003-4819-134-7-200104030-00007
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Knee osteoarthritis affects 11% to 15% of the U.S. population 65 years of age or older (1) and is a leading cause of disability in the elderly. The major source of disability and care seeking for patients with osteoarthritis is pain in the knee (2).

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Figure 1.
Sources of study participants.

VA = Veterans Administration.

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Figure 2.
Grades of bone marrow lesions.Top.Middle.Bottom.

Two grade 1 lesions beneath the medial femoral condyle and medial tibial plateau. Both lesions were seen on one adjacent slice. Grade 2 lesion beneath the medial tibial plateau. This particular lesion was seen on three adjacent slices. Grade 3 lesion beneath the medial femoral condyle, seen on four adjacent slices. Small grade 1 lesions (which still sum to a grade 1 lesion on the basis of the total volume of lesions) on the medial tibial plateau are also visible.

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Summary for Patients

The Association of Bone Marrow Lesions with Pain in Knee Osteoarthritis

The summary below is from the full report titled “The Association of Bone Marrow Lesions with Pain in Knee Osteoarthritis.” It is in the 3 April 2001 issue of Annals of Internal Medicine (volume 134, pages 541-549). The authors are DT Felson, CE Chaisson, CL Hill, SMS Totterman, ME Gale, KM Skinner, L Kazis, and DR Gale.

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