Bone Marrow Changes in Acute and Chronic Trauma

Vanhoenacker, Filip; Eyselbergs, Michiel; Demeyere, Annick

doi:10.1007/174_2011_444

Cited by 3 publications

(4 citation statements)

References 56 publications

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“…Hallmark is the so called bone marrow edema like signal (henceforth called edema-equivalent signal-changes EESC), characterized by ill-defined areas of high (water-isointense) signal intensity on T2w and STIR sequences in bone, together with similar signals in the adjacent soft tissues [7–10]. EESC may be depicted on T1w images as hypointense signal.…”

Section: Introductionmentioning

confidence: 99%

Follow up of MRI bone marrow edema in the treated diabetic Charcot foot – a review of patient charts

Chantelau

Antoniou

Zweck

et al. 2018

Diabetic Foot & Ankle

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Background: Ill-defined areas of water-like signal on bone magnetic resonance imaging (MRI), characterized as bone marrow edema or edema-equivalent signal-changes (EESC), is a hallmark of active-stage pedal neuro-osteoarthropathy (Charcot foot) in painless diabetic neuropathy, and is accompanied by local soft-tissue edema and hyperthermia. The longitudinal effects on EESC of treating the foot in a walking cast were elucidated by reviewing consecutive cases of a diabetic foot clinic. Study design: Retrospective observational study, chart review Material and methods: Cases with active-stage Charcot foot were considered, in whom written reports on baseline and follow-up MRI studies were available for assessment. Only cases without concomitant infection or skin ulcer were chosen, in whom both was documented, onset of symptomatic foot swelling and patient compliance with cast treatment. Results: From 1994 to 2017, 45 consecutive cases in 37 patients were retrieved, with 95 MRI follow-up studies (1–6 per case, average interval between studies 13 weeks). Decreasing EESC was documented in 66/95 (69%) follow-up studies. However, 29/95 (31%) studies revealed temporarily increasing, migrating or stagnating EESC. Conclusion: EESC on MRI disappear in response to prolonged offloading and immobilizing treatment; however, physiologic as well as pathologic fluctuations of posttraumatic EESC have to be considered when interpreting the MR images. Conventional MRI is useful for surveillance of active-stage Charcot foot recovery.

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Section: Introductionmentioning

confidence: 99%

Follow up of MRI bone marrow edema in the treated diabetic Charcot foot – a review of patient charts

Chantelau

Antoniou

Zweck

et al. 2018

Diabetic Foot & Ankle

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“…We presented a subtle case of Lisfranc fracture in a pregnant patient with preeclampsia, whose MRI demonstrated minimal post-traumatic bone marrow edema. To our knowledge, there are some reported cases of variability in the presence or degree of bone marrow edema in the post-traumatic setting with proven acute fracture [7,8,11], and we propose that certain circumstances may affect the reliable manifestation of bone marrow edema.…”

Section: Discussionmentioning

confidence: 92%

“…Post-traumatic bone marrow edema is thought to precede clinically apparent fracture and can serve as a telling clue for detecting areas of abnormality when radiographic and computed tomography (CT) imaging modalities fail to reveal an obvious fracture line [4][5][6]18]. The location and distribution of bone marrow edema can provide clues about the etiology and mechanism of injury [7,8,10,19]. For Lisfranc fractures, depending on the direction of dislocation (homolateral, divergent, or isolated), patterns of bone marrow edema may vary [4].…”

Section: Discussionmentioning

confidence: 99%

Absence of Posttraumatic Bone Marrow Edema in the Setting of Preeclampsia

Shiang¹,

Tai²,

Watts³

2021

Journal of the American Podiatric Medical Association

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Magnetic resonance imaging (MRI) is a powerful tool in the diagnosis of missed or occult fractures on radiographic and computed tomography (CT) imaging, through the detection of bone marrow edema. While radiologists often rely on bone marrow edema as a guide for diagnosing subtle underlying fractures, it is important to recognize its limitations as a diagnostic metric. We present a rare case demonstrating the absence of bone marrow edema after acute trauma and confirmed Lisfranc fracture in a patient with preeclampsia and propose an interesting physiologic mechanism to explain this manifestation.

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“…Oedematous bone resembles "wet zwieback", as a surgeon would say. The time course of bone marrow oedema after a bone trauma has to be considered: it becomes visible only about 3 hours after the inciting event, expands over the next 1 to 2 months, and regresses during the following 3 to 10 months (depending on the extent of the bone injury and the treatment efficacy) [34,42,43].…”

Section: Mri Should Replace X-ray For Diagnosing and Monitoring The C...mentioning

confidence: 99%

Is the Eichenholtz classification still valid for the diabetic Charcot foot?

Chantelau¹,

G²

2014

Swiss Med Wkly

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In his 1966 monograph "Charcot joints", Sidney N. Eichenholtz (1909-2000) described "three well defined stages … in the course and development of a Charcot joint", based on plain X-rays of 68 patients. Since then, medical imaging has advanced very much: computed tomography and magnetic resonance imaging (MRI) scans exceed plain X-ray by far in detecting foot fractures and other injuries. The earliest, nondeforming, X-ray-negative inflammatory stage of the acute Charcot joint of the diabetic foot can be visualised only by use of MRI. This stage, which Eichenholtz evidently failed to recognise, will heal without significant arthropathy, if treated in time. By contrast, the stages considered by Eichenholtz inevitably result in major arthropathy and foot deformity. Hence, superseding the Eichenholtz classification is overdue. We propose an MRI-based classification comprising two severity grades (0 and 1, according to absence/presence of cortical fractures) and two stages (active/inactive, according to presence/absence of skeletal inflammation).

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Bone Marrow Changes in Acute and Chronic Trauma

Cited by 3 publications

References 56 publications

Follow up of MRI bone marrow edema in the treated diabetic Charcot foot – a review of patient charts

Follow up of MRI bone marrow edema in the treated diabetic Charcot foot – a review of patient charts

Absence of Posttraumatic Bone Marrow Edema in the Setting of Preeclampsia

Is the Eichenholtz classification still valid for the diabetic Charcot foot?

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