Perfusion abnormalities in subchondral bone associated with marrow edema, osteoarthritis, and avascular necrosis

Roy K. Aaron, Jonathan P. Dyke, Deborah McK Ciombor, Douglas Ballon, Jonathan H. Lee, Edward Jung, Glenn A. Tung

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Bone marrow edema is seen in osteoarthritis, avascular necrosis, and other clinical conditions including the bone marrow edema syndrome. Bone marrow edema is associated with bone pain and may be related to the pathophysiology of osteoarthritis. Our hypothesis is that bone marrow edema is associated with a reduction in perfusion in subchondral bone, which contributes to focal and segmental bone necrosis and cartilage breakdown. We further hypothesize that altered fluid dynamics in subchondral bone comprise part of the physicochemical environment to which osteocytes are highly sensitive and alter their cytokine expression profile in response to changes in fluid flow, pressure, and oxygen gradients. We have used contrast-enhanced magnetic resonance imaging with Gd-DTPA to characterize changes in subchondral bone perfusion in two relevant and related models - the Dunkin-Hartley guinea pig model of osteoarthritis and human bone marrow edema associated with osteoarthritis and avascular necrosis. Pharmacokinetic modeling was used to extract dynamic parameters of perfusion. Representative time-intensity curves are derived, which characterize normal bone and bone with marrow edema. Dynamic contrast-enhanced magnetic resonance imaging may be a useful tool for the early diagnosis of bone perfusion abnormalities and may be used to characterize marrow edema associated with a number of clinical conditions. This technique may also shed light on the pathophysiology of subchondral perfusion in osteoarthritis and avascular necrosis.

Original languageEnglish (US)
Pages (from-to)124-137
Number of pages14
JournalAnnals of the New York Academy of Sciences
Volume1117
DOIs
StatePublished - Nov 2007
Externally publishedYes

Fingerprint

Osteoarthritis
Edema
Bone
Necrosis
Perfusion
Bone Marrow
Bone and Bones
Magnetic Resonance Imaging
Osteocytes
Gadolinium DTPA
Osteonecrosis
Magnetic resonance
Hydrodynamics
Marrow
Cartilage
Early Diagnosis
Guinea Pigs
Pharmacokinetics
Imaging techniques
Cytokines

Keywords

  • Avascular necrosis
  • Bone marrow edema
  • Bone perfusion abnormalities
  • Dynamic contrast-enhanced MRI
  • Osteoarthritis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Perfusion abnormalities in subchondral bone associated with marrow edema, osteoarthritis, and avascular necrosis. / Aaron, Roy K.; Dyke, Jonathan P.; Ciombor, Deborah McK; Ballon, Douglas; Lee, Jonathan H.; Jung, Edward; Tung, Glenn A.

In: Annals of the New York Academy of Sciences, Vol. 1117, 11.2007, p. 124-137.

Research output: Contribution to journalArticle

Aaron, Roy K. ; Dyke, Jonathan P. ; Ciombor, Deborah McK ; Ballon, Douglas ; Lee, Jonathan H. ; Jung, Edward ; Tung, Glenn A. / Perfusion abnormalities in subchondral bone associated with marrow edema, osteoarthritis, and avascular necrosis. In: Annals of the New York Academy of Sciences. 2007 ; Vol. 1117. pp. 124-137.
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