Edema of the Bone Marrow Can Cause Pain in Osteoarthritis and Other Diseases of Bone and Joints
Authors: Alfred Jay Bollet
Journal: Annals of Internal Medicine (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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McQueen FM, Stewart N, Crabbe J, Robinson E, Yeoman S, Tan PL, et al . Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals progression of erosions despite clinical improvement. Ann Rheum Dis. 1999;58:156-63. [PMID: 0010364913] CrossrefMedlineGoogle Scholar9. Arnoldi CC, Djurhuus JC, Heerfordt J, Karle A. Intraosseous phlebography, intraosseous pressure measurements and 99mTC-polyphosphate scintigraphy in patients with various painful conditions in the hip and knee. Acta Orthop Scand. 1980;51:19-28. [PMID: 0007376840] CrossrefMedlineGoogle Scholar10. Koo KH, Ahn IO, Kim R, Song HR, Jeong ST, Na JB, et al . Bone marrow edema and associated pain in early stage osteonecrosis of the femoral head: prospective study with serial MR images. Radiology. 1999;213:715-22. [PMID: 0010580944] CrossrefMedlineGoogle Scholar11. Lotke PA, Ecker ML, Barth P, Lonner JH. Subchondral magnetic resonance imaging changes in early osteoarthrosis associated with tibial osteonecrosis. 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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