title: The clinical significance, natural history and predictors of bone marrow lesion change over eight years.
abstract: BACKGROUND
  There is increasing evidence to suggest that bone marrow lesions (BMLs) play a key role in the pathogenesis of osteoarthritis (OA). However, there is a lack of long term data. The aim of this study was to describe the natural history of knee BMLs, their association with knee pain and examine predictors of BML change over eight years.
  
  
  METHODS
  A total of 198 subjects (109 adult offspring of subjects who had a knee replacement and 89 community-based controls) were studied. Knee pain and BML size were assessed at two and ten year visits.
  
  
  RESULTS
  At the two year visit, 64% of participants (n = 127) had 229 BMLs (34% patella, 26% femoral and 40% tibial). Over eight years, 24% (55/229) increased in size, 55% (125/229) remained stable and 21% (49/229) decreased in size or resolved completely. Of the participants without BMLs at baseline, 52% (37/71) developed incident BMLs.
  
  
  CONCLUSIONS
  In this midlife cohort, the proportion of BMLs increasing in size was similar to those decreasing in size with the majority remaining stable. Change in BMLs was predicted by BMI and strenuous activity. An increase in BML size or a new BML resulted in an increase in pain especially in males and those with a family history of OA.
authors.forename: Yi Chao
authors.initials: YC
authors.lastname: Foong
authors.forename: Hussain Ijaz
authors.initials: HI
authors.lastname: Khan
authors.forename: Leigh
authors.initials: L
authors.lastname: Blizzard
authors.forename: Changhai
authors.initials: C
authors.lastname: Ding
authors.forename: Flavia
authors.initials: F
authors.lastname: Cicuttini
authors.forename: Graeme
authors.initials: G
authors.lastname: Jones
authors.forename: Dawn
authors.initials: D
authors.lastname: Aitken
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D006801:Humans; D007717:Knee / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D020370:Osteoarthritis, Knee / Q000150:complications / Q000473:pathology*; D010146:Pain / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology