Knee damage appearing on MRI predicts arthritis ahead

Knee damage appearing on MRI predicts arthritis ahead

Source: Northwestern University Feinberg School of Medicine

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People who are at higher risk to develop knee osteoarthritis (OA) from being overweight or having injured their knee in the past may have normal X-rays, but worsening lesions or damage appearing on their MRIs predicts a significantly higher risk of soon developing knee osteoarthritis or painful symptoms, reports a new Northwestern Medicine study.

Depending on the type of lesion, their risk of developing knee OA within three years as diagnosed by X-ray is three to 20 times greater.

“These worsening lesions are an early warning sign and an opportunity to intervene before a person develops the debilitating disease,” said lead investigator Leena Sharma, M.D. “If we employ aggressive prevention strategies in persons with these lesions before they develop knee osteoarthritis, we may be able to delay disease development or alter its course.”

Sharma is a professor of medicine at Northwestern University Feinberg School of Medicine and a Northwestern Medicine rheumatologist.

Prevention strategies include paying attention to weight and carefully reviewing physical activity to avoid potentially damaging activity and injury, said Sharma, also the Solovy Arthritis Research Society research professor.

This is the first study to examine and determine the impact of knee lesions in persons at higher risk for knee OA with normal X-rays. Previously, it wasn’t known whether the lesions predicted the new development of OA or future symptoms such as frequent knee pain. Many scientists had thought these lesions were insignificant and simply the result of aging, though in the last few years, the lesions have sparked more suspicion.

The study was published in October in the Annals of the Rheumatic Diseases.

Among Americans 55 years and older, 40 percent have frequent knee pain or knee osteoarthritis. In the elderly, knee OA is responsible for as much chronic disability as cardiovascular disease. Current treatments may help symptoms but do not delay progression of the disease.

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