Bone marrow edema around the hip in non-traumatic pain: dual-energy CT vs MRI

Identification of bone marrow edema around the ankle joint in non-traumatic patients: Diagnostic accuracy of dual-energy computed tomography

“…In another study, non-traumatic BME around the hip was diagnosed with 95.45% sensitivity and 86.67% specificity. For both readers, the BME detection rate was higher in patients with severe edema as opposed to mild [32]. In our study, the BME detection rate for DECT was similar in the sub-groups of patients with mild and severe BME.…”

“…Dual-energy computed tomography (DECT) has been employed for the identification of BME in compression vertebral fracture [21][22][23], and for the identification of traumatic BME of the lower limbs [24][25][26][27][28][29][30]. DECT has also recently been used for the diagnosis of non-traumatic BME around the hip joint [31,32]. Furthermore, virtual non-calcium (VNCa) applications have been used for diagnosing BME of the ankle in a mixed cohort of traumatic and non-traumatic patients [33].…”

Identification of Traumatic Bone Marrow Oedema: The Pearls and Pitfalls of Dual-Energy CT (DECT)

“…Additional windowing can also be carried out by increasing or decreasing the level of super-imposition of color-coded images in order to confirm or rule out subtler findings (Figure 2). However, in selected cases, for example in those of bone sclerosis, an alternative and widely used color-coding method, whereby spared bone is represented in violet and BME in shades of green, is preferred; this highlights an important pitfall of DECT [3,7,8]. Sclerosis is often identified on the acetabular roof, especially in patients suffering from degenerative osteoarthritis of the hip, or near to the pubis and sacroiliac joints, in the subchondral areas of knee and ankle, such as the tibial plateaus and talar dome, and adjacent to cortical bone in the upper extremities.…”

“…By working on the BME threshold and on the level of super-imposition, it is usually possible to more accurately determine the location and distribution of BME. Furthermore, DECT seems to be more accurate in diagnosing severe BME than milder, subtler oedema [8]. In selected cases, the quantitative assessment of DECT numbers, using an ROI in areas of less obvious BME, can help in achieving a differential diagnosis.…”

Bone marrow edema in terms of joint pathology

“…Сегодня в практическую медицину внедрен относительно новый метод диагностики -двухэнергетическая компьютерная томография, которая, по некоторым данным, может лучше, чем МРТ, идентифицировать отек костного мозга вокруг тазобедренного и других суставов [7].…”