title: The natural history of bone marrow lesions in community-based middle-aged women without clinical knee osteoarthritis.
abstract: OBJECTIVE
  Bone marrow lesions (BML) have been implicated in the pathogenesis of osteoarthritis, yet their exact role, etiology, and natural history remain unclear. The aim of this study was to examine the natural history of BML in a healthy population and identify risk factors associated with their persistence and incidence.
  
  
  METHODS
  One hundred forty-eight healthy middle-aged women had magnetic resonance imaging performed on their dominant knee at baseline and 2 years later to assess the presence, natural history, and risk factors for persistence and incidence of BML.
  
  
  RESULTS
  Approximately 46% of BML present at baseline completely resolved over 2 years. "Large" BML had the potential to improve, while the majority of "very large" remained stable. In those women with no BML at baseline, approximately 9% developed a BML over 2 years, the majority in the medial compartment. There was a trend toward weight being a risk factor for the development of "very large" BML (P = 0.08).
  
  
  CONCLUSIONS
  The natural history of BML may be different in healthy persons compared with diseased states. The trend for weight as a risk factor for development of a "very-large" BML suggests there is potential to identify modifiable risk factors for BML in asymptomatic people and warrants further investigation.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University Medical School, Alfred Hospital, Victoria, Australia. Patricia.Berry@med.monash.edu.au
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Berry
authors.forename: Miranda L
authors.initials: ML
authors.lastname: Davies-Tuck
authors.forename: Anita E
authors.initials: AE
authors.lastname: Wluka
authors.forename: Fahad S
authors.initials: FS
authors.lastname: Hanna
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Bell
authors.forename: Susan R
authors.initials: SR
authors.lastname: Davis
authors.forename: Jenny
authors.initials: J
authors.lastname: Adams
authors.forename: Flavia M
authors.initials: FM
authors.lastname: Cicuttini
mesh_terms: D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D001855:Bone Marrow Diseases / Q000150:complications / Q000453:epidemiology* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors