Bone Marrow Lesions in Knee Osteoarthritis Imaging
Summary
Bone marrow lesions (BMLs) are focal areas of altered signal intensity within the subchondral bone that emerge in the course of knee osteoarthritis. Detected most commonly by magnetic resonance imaging, these lesions correspond to histopathological changes including fibrosis, neovascularisation, cartilage intrusion and abnormal bone remodelling. BMLs have been closely linked to pain severity, structural progression and risk of joint replacement, making them valuable biomarkers for disease staging and therapeutic monitoring. Advanced imaging techniques have refined our understanding of BML phenotypes, while quantitative metrics now allow precise measurement of lesion volume, texture and mineral composition. Clinically, recognition of BML dynamics offers opportunities for targeted interventions aimed at modulating bone turnover, alleviating pain and slowing cartilage loss. Recent studies have further underlined the role of BMLs in predicting site-specific cartilage defects, guiding personalised management in early and established disease.
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Bone Marrow Lesions in Knee Osteoarthritis Imaging publication trend
The graph below shows the total number of articles in bone marrow lesions in knee osteoarthritis imaging across all publications each year (not limited to Nature Index journals).
Technical terms
Bone marrow lesion (BML): Focal subchondral bone region exhibiting signal alterations on MRI, indicative of pathological remodelling and associated with pain and structural progression.
Magnetic resonance imaging (MRI): Imaging modality that uses strong magnetic fields and radiofrequency pulses to generate detailed images of soft tissues and bone marrow without ionising radiation.
Radiomics: Quantitative approach to extract high-dimensional imaging features, such as texture and shape, to characterise tissue heterogeneity and inform diagnosis or prognosis.
Dual-energy CT (DECT): Computed tomography method employing two distinct X-ray energy spectra to differentiate materials, enabling virtual subtraction of calcium for enhanced detection of marrow oedema.
References
- Radiomics analysis using magnetic resonance imaging of bone marrow edema for diagnosing knee osteoarthritis. Frontiers in Bioengineering and Biotechnology (2024).
- Dual-energy CT virtual non-calcium: an accurate method for detection of knee osteoarthritis-related edema-like marrow signal intensity. Insights into Imaging (2023).
- Radiomics Texture Analysis of Bone Marrow Alterations in MRI Knee Examinations. Journal of Imaging (2023).
- Bone marrow lesions from osteoarthritis knees are characterized by sclerotic bone that is less well mineralized. Arthritis Research & Therapy (2009).
- Evaluation of bone marrow lesion volume as a knee osteoarthritis biomarker - longitudinal relationships with pain and structural changes: data from the Osteoarthritis Initiative. Arthritis Research & Therapy (2013).
- Bone marrow edema in the knee in osteoarthrosis and association with total knee arthroplasty within a three-year follow-up. Skeletal Radiology (2008).
- Bone marrow lesions predict site-specific cartilage defect development and volume loss: a prospective study in older adults. Arthritis Research & Therapy (2010).
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