早期膝OAの病態

福井 尚志, 田中 信帆, 大橋 暁, 岩澤 三康

doi:10.11551/jsjd.38.79

Early osteoarthritis (OA) may be defined as the condition when symptoms of OA appear while joint space narrowing is not evident on plain radiographs. Recent epidemiological studies have shown that degenerative changes may accumulate within the joints with aging, which may account for the generation of pain in joints with early OA. For established OA, in which joint space narrowing is apparent on plain radiographs, bone marrow lesions (BMLs) detected by magnetic resonance imaging (MRI) have been determined to cause joint pain. It is also known that the presence of BMLs is a risk factor for structural progression of the disease. Similarly, the presence of joint effusion or synovitis on MRI is another pathology that is closely associated with pain and progression of the disease. In contrast, relatively little is known about early OA as to the pathologies that cause the symptoms. The results of published studies have suggested that, in analogy to established OA, BMLs can cause pain in early disease. The presence of cartilage degeneration, meniscal abnormalities, and formation of osteophytes on MRI are also reported to be associated with pain in joints with early OA. However, these pathologies may be general changes associated with aging, and are probably not closely related to the generation of pain. More work seems necessary to determine the changes that cause pain in joints with early OA. In OA, pain is a potent risk factor for progression of the disease. Further understanding of the changes that cause pain in early disease may be necessary and helpful in finding effective treatments for it, which not only improve symptoms but also prevent progression.

早期膝OAの病態

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