Zimmer Inc., 9301 Amberglen Blvd, Austin, TX 78729, USA.
Rheumatol Int. 2011 Feb;31(2):143-8. doi: 10.1007/s00296-010-1454-x. Epub 2010 Apr 3.
Osteoarthritis (OA) is considered a multifactorial disease whose development and progression may include several structural abnormalities aside from cartilage destruction. Bone marrow lesions (BMLs) have been reported to be associated with OA pathology, and several studies have advocated its close connection to the severity of joint structural alterations and pain, the main OA clinical manifestation. Hence, BMLs may not only affect subchondral bone and its neuronal and vascular structures but also negatively influence the adjacent tissues. Here, we analyze the pathophysiology and natural history of OA-associated BMLs and their potential relevance to the radiographic progression and severity of the disease. The notion that BMLs may be a precursor to additional articular abnormalities, can be a potential risk factor for development of OA, and may serve as an additional diagnostic tool and a therapeutic target are further discussed.
骨关节炎（OA）被认为是一种多因素疾病，其发展和进展除了软骨破坏外，还可能包括几种结构异常。骨髓病变（BML）已被报道与 OA 病理学有关，多项研究主张其与关节结构改变和疼痛的严重程度密切相关，而疼痛是 OA 的主要临床表现。因此，BML 不仅可能影响软骨下骨及其神经元和血管结构，还可能对相邻组织产生负面影响。在这里，我们分析了与 OA 相关的 BML 的病理生理学和自然史及其与疾病放射学进展和严重程度的潜在相关性。BML 可能是关节其他异常的前兆，可能是 OA 发展的潜在危险因素，也可能作为一种额外的诊断工具和治疗靶点，这一点值得进一步讨论。
