Bone marrow lesions and collateral ligament lesions are associated in interphalangeal joints with osteoarthritis: the Hand OSTeoArthritis in Secondary care cohort

Abstract

Objectives: To investigate whether bone activity adjacent to collateral ligaments is present and results in collateral ligament lesions (CLLs) of the proximal and distal interphalangeal joints in patients with hand osteoarthritis (OA), and vice versa. Methods: We used data measured on baseline, year two and year four from the Hand OSTeoArthritis in Secondary care cohort. MR images of the right hand were scored at the radial and ulnar 1/3rd of each joint ("=joint side") for bone marrow lesions (BMLs) and CLLs (=non-visible or non-continuous ligament). Odds ratios (ORs) with 95% confidence intervals were used to quantify longitudinal associations at the same joint side, adjusted for patient effect. Results: In 261 patients (mean age 61 years, 84% women), BMLs were present at baseline in 113/4169 joint sides (3%), and at year four in 89/3356 (3%). Any CLL was present at baseline in 500/4169 joint sides (12%), and at year four in 559/3356 (17%). The presence of BMLs and CLL was cross-sectionally associated. In baseline joint sides without CLLs, BMLs were positively associated with CLL development in the corresponding joint side at year two and four (OR 3.7 (1.5;9.1) and 4.9 (2.3;10.7), respectively), compared with no BMLs. In baseline joint sides without BMLs, CLLs were positively associated with BMLs at the same side at year two and four (9.2 (3.9;22.1) and 11.0 (5.8;20.9) respectively), compared with no CLLs. Conclusions: BMLs are rare yet associated with CLLs that are more common, both cross-sectionally and longitudinally, both adding to the OA process. (c) 2025 The Authors. Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).