Objective: To describe the frequency of bonemarrowlesions (BMLs) detected bymagnetic resonance imaging
(MRI), and to examine the association of BMLs with knee pain severity in community residents in Korea.
Methods: Participants were randomly chosen from the population-based Hallym Aging Study, irrespective
of whether they had knee osteoarthritis (OA) or pain. Demographic and knee pain data were obtained by
questionnaire. Radiographic evaluations consisted of weight-bearing knee anteroposterior radiographs and
1.5-T MRI scans. MRI was performed in the dominant knees of subjects without knee pain and in the more
symptomatic knees of subjects with knee pain. BMLs were graded according to the whole-organ MRI score.
Results: The mean age of the 358 study subjects was 71.8 years, and 34.5% of subjects had radiographically
detected knee OA. The prevalences of BMLs and large BMLs in the tibiofemoral compartments were
80.3% and 40.4%, respectively. After adjusting for age, sex, and body mass index, total and medial
compartment BML scores were significantly associated with the presence of knee pain, and the association
was stronger as the summary score for BML increased. In proportional regression analysis, knee
pain severity increased with BML severity in any compartment and in the medial compartment.
Conclusion: BMLs detected by MRI were highly prevalent in this elderly Asian population. BMLs were
significantly linked to knee pain, and BML severity correlated with knee pain severity. BMLs may be
important surrogate targets for monitoring pain and structure modification in OA therapeutics.