膝骨性关节炎软骨下骨髓水肿样变的研究进展

Research progress of bone marrow edema-like lesions in knee osteoarthritis

膝骨性关节炎相关的骨髓水肿样变(knee osteoarthritis-associated bone marrow edema-like lesions,KOABMLs)是一种常见的MRI影像学特征,主要表现为T2成像上软骨下骨的异常骨髓高信号。KOA-BMLs的形成可能与下肢力线以及软骨下骨灌注异常有关,而相关的组织病理学研究表明,这些损伤区域骨和骨髓的重建异常增加。在KOA患者中BMLs的大小可以在相对较短的时间内发生波动甚至消失,并且与疼痛、软骨下骨囊肿形成以及KOA病程进展密切相关。但是当前KOA-BMLs的治疗方法有限,并且尚无统一的指南或专家共识,主要包括药物治疗、物理疗法以及手术治疗。本文就KOA-BMLs的疾病特点及治疗的研究进展进行了综述,以期为KOA-BMLs的临床诊疗提供指导。

Knee osteoarthritis-associated bone marrow edema-like lesions(KOA-BMLs) is a common MRI imaging feature,which is mainly manifested as abnormal bone marrow hyperintensity in subchondral bone on T2 imaging.The formation of KOA-BMLs may be related to the abnormality of lower limb force line and subchondral bone perfusion,and related histopathological studies showed that the remodeling of bone and bone marrow in these damaged areas was abnormally increased.In KOA patients,the size of BMLs can fluctuate or even disappear in a relatively short period of time,and was closely related to pain,subchondral bone cyst formation,and the progression of KOA.However,the current treatment methods for KOA-BMLs are limited,and there is no uniform guideline or expert consensus,mainly including medication,physical therapy and surgical treatment.This article reviews the research progress of the disease characteristics and treatment of KOA-BMLs in order to provide guidance for the clinical diagnosis and treatment of KOA-BMLs.