Edema of the Bone Marrow Can Cause Pain in Osteoarthritis and Other Diseases of Bone and Joints (2001)

Editorials3 April 2001Edema of the Bone Marrow Can Cause Pain in Osteoarthritis and Other Diseases of Bone and JointsAlfred Jay Bollet, MDAlfred Jay Bollet, MDDr. Bollet: Sands Point, NY 11050Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-7-200104030-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Cartilage degeneration, although fundamental to the pathogenesis of osteoarthritis, is not the site of origin of pain, the predominant symptom of osteoarthritis. Peripheral nerves generally follow the path of blood vessels, and cartilage contains no nerves or blood vessels. Pain can originate in the synovium, the joint capsule, or intra-articular ligaments, as well as in the muscles and soft tissues, which surround and move the joint in osteoarthritis.Ordinary radiographs show the effect of degeneration of joint cartilage as narrowing of the space between the surfaces of the articular bone (usually called the "joint space" or, more accurately, the "cartilage ...References1. Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, et al . The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med. 2001;134:541-9. LinkGoogle Scholar2. Grampp S, Henk CB, Mostbeck GH. Overuse edema in the bone marrow of the hand: demonstration with MRI. J Comput Assist Tomogr. 1998;22:25-7. [PMID: 0009448756] CrossrefMedlineGoogle Scholar3. Wojtys EM, Beaman DN, Glover RA, Janda D. Innervation of the human knee joint by substance-P fibers. Arthroscopy. 1990;6:254-63. [PMID: 0001702291] CrossrefMedlineGoogle Scholar4. 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Arthroscopy. 2000;16:76-81. [PMID: 0010627350] CrossrefMedlineGoogle Scholar12. Castro FP, Barrack RL. Core decompression and conservative treatment for avascular necrosis of the femoral head: a meta-analysis. Am J Orthop. 2000;29:187-94. [PMID: 0010746469] MedlineGoogle Scholar13. Boegard T, Rudling O, Dahlstrom J, Dirksen H, Petersson IF, Jonsson K. Bone scintigraphy in chronic knee pain: comparison with magnetic resonance imaging. Ann Rheum Dis. 1999;58:20-6. [PMID: 0010343536] CrossrefMedlineGoogle Scholar14. Dieppe P. Subchondral bone should be the main target for the treatment of pain and disease progression in osteoarthritis. Osteoarthritis Cartilage. 1999;7:325-6. [PMID: 0010329316] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Dr. Bollet: Sands Point, NY 11050Current Author Address: Dr. Bollet: 22 Plum Beach Point Road, Sands Point, NY 11050. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Association of Bone Marrow Lesions with Pain in Knee Osteoarthritis David T. Felson , Christine E. Chaisson , Catherine L. Hill , Saara M.S. Totterman , M. Elon Gale , Katherine M. Skinner , Lewis Kazis , and Daniel R. 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