UMMS Affiliation

Department of Medicine, Division of Rheumatology

Publication Date

1-2015

Document Type

Article

Subjects

Aged; Animals; Anterior Cruciate Ligament; Arthritis, Experimental; Blood Vessels; Bone and Bones; Cartilage, Articular; Female; Humans; Knee Joint; Magnetic Resonance Imaging; Male; Mice; Middle Aged; Osteoarthritis, Knee; Posterior Cruciate Ligament

Disciplines

Musculoskeletal Diseases | Rheumatology | Skin and Connective Tissue Diseases

Abstract

OBJECTIVES: The purpose of this work was to test whether normal peri-entheseal vascular anatomy at anterior and posterior cruciate ligaments (ACL and PCL) was associated with distribution of peri-entheseal bone erosion/bone marrow lesions (BMLs) in inflammatory arthritis (IA) and osteoarthritis (OA).

METHODS: Normal microanatomy was defined histologically in mice and by 3 T MRI and histology in 21 cadaveric knees. MRI of 89 patients from the Osteoarthritis Initiative and 27 patients with IA was evaluated for BMLs at ACL and PCL entheses. Antigen-induced arthritis (AIA) in mice was evaluated to ascertain whether putative peri-entheseal vascular regions influenced osteitis and bone erosion.

RESULTS: Vascular channels penetrating cortical bone were identified in knees of non-arthritic mice adjacent to the cruciate ligaments. On MRI of normal cadavers, vascular channels adjacent to the ACL (64% of cases) and PCL (71%) entheses were observed. Histology of 10 macroscopically normal cadaveric specimens confirmed the location of vascular channels and associated subclinical changes including subchondral bone damage (80% of cases) and micro-cyst formation (50%). In the AIA model, vascular channels clearly provided a site for inflammatory tissue entry and osteoclast activation. MRI showed BMLs in the same topographic locations in both patients with early OA (41% ACL, 59% PCL) and IA (44%, 33%).

CONCLUSION: The findings show that normal ACL and PCL entheses have immediately adjacent vascular channels which are common sites of subtle bone marrow pathology in non-arthritic joints. These channels appear to be key determinants in bone damage in inflammatory and degenerative arthritis. already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Keywords

Inflammation, Knee Osteoarthritis, Magnetic Resonance Imaging, Osteoarthritis, Rheumatoid Arthritis

DOI of Published Version

10.1136/annrheumdis-2013-203972

Source

Ann Rheum Dis. 2015 Jan;74(1):196-203. doi: 10.1136/annrheumdis-2013-203972. Epub 2013 Oct 4. Link to article on publisher's site

Journal/Book/Conference Title

Annals of the rheumatic diseases

Related Resources

Link to Article in PubMed

PubMed ID

24095939

Creative Commons License

Creative Commons Attribution 3.0 License
This work is licensed under a Creative Commons Attribution 3.0 License.

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.