Bone marrow changes on STIR MR images of asymptomatic feet and ankles

Abstract

The purpose of this study was to evaluate the prevalence, pattern and size of bone marrow changes on short-tau inversion recovery (STIR) magnetic resonance (MR) images of asymptomatic feet and ankles. In 78 asymptomatic volunteers (41 women, 37 men; median age 47 years; range 23-83 years) sagittal STIR MR images of hindfoot and midfoot were reviewed for various patterns of high signal changes in bone marrow. The size of these bone marrow changes was measured, and signal intensity was rated semi-quantitatively using a scale from 0(=normal) to 10(=fluid-like). Fifty percent (39/78) of all volunteers had at least one bone marrow change. Thirty-six percent (28/78) of all volunteers had edemalike changes, 26% (20/78) had necrosis-like changes, and 5% (4/78) had cyst-like changes. The long diameters of all changes varied between 4 mm and 16 mm (median 7.5 mm). The median signal intensity for all changes was 5.0 (range 1-10). Bone marrow changes on STIR MR images are commonly detected in asymptomatic feet and ankles. However, such changes tend to be small (<1 cm) or subtle.

Diagnostic Performance of Dual-Energy CT for the Detection of Traumatic Bone Marrow Lesions in the Ankle: Comparison with MR Imaging

“…T he ankle is the most commonly injured joint in the body, and ankle fractures are among the most common type of fractures (1). Typical findings in acute ankle trauma include ligamentous and synovial injury, osteochondral and osseous lesions, and traumatic bone marrow lesions (also referred to as bone bruises) (2)(3)(4)(5)(6)(7)(8).…”

Bone marrow lesions in the knee: the clinical conundrum

“…The authors concluded that these BME changes did not warrant any further workup or treatment unless accompanied by a complaint. 28 In another study examining the natural history of BMLs in the knee, 234/271 participants had no BML at baseline.…”

Founder’s lecture of the ISS 2006: borderlands of normal and early pathological findings in MRI of the foot and ankle

“…Such abnormalities are clinically relevant and are often associated with pain [26,[34][35][36]. On the other hand, an increased signal on STIR images may also represent normal variants or clinically asymptomatic abnormalities [37]. Bone marrow changes on STIR MR images are commonly (50% [37]) detected in asymptomatic feet and ankles.…”

“…On the other hand, an increased signal on STIR images may also represent normal variants or clinically asymptomatic abnormalities [37]. Bone marrow changes on STIR MR images are commonly (50% [37]) detected in asymptomatic feet and ankles. However, they are very small (<1 cm) or subtle and should not lead to further diagnostic workup or treatment without any additional abnormalities.…”

“…Bone marrow changes just inferior to angle of Gissane are commonly seen in asymptomatic volunteers [37]. These lesions represent intraosseous ganglion cysts or remnant vessels penetrating the superior calcaneal cortex [41,42].…”