Bone Marrow Edema Patterns in the Ankle and Hindfoot: Distinguishing MRI Features

Rios, Adriana Martins; Rosenberg, Zehava Sadka; Bencardino, Jenny T.; Rodrigo, Silvia Pérez; Theran, Sara García

doi:10.2214/ajr.10.5880

Cited by 55 publications

(53 citation statements)

References 15 publications

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“…Associated MRI findings such as osteophytes and diffuse articular cartilage loss in OA (Fig. 4B), and periarticular soft-tissue edema, synovitis, and marginal erosions in rheumatoid arthritis, can aid in the diagnosis (81). …”

Section: Resultsmentioning

confidence: 99%

Magnetic Resonance Imaging of Subchondral Bone Marrow Lesions in Association with Osteoarthritis

Hayashi

Roemer

et al. 2012

Seminars in Arthritis and Rheumatism

100

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Objectives This nonsystematic literature review provides an overview of magnetic resonance imaging (MRI) of subchondral bone marrow lesions (BMLs) in association with osteoarthritis (OA), with particular attention to the selection of MRI sequences and semiquantitative scoring systems, characteristic morphology, and differential diagnosis. Histologic basis, natural history, and clinical significance are also briefly discussed. Methods PubMed was searched for articles published up to 2011, using the keywords bone marrow lesion, osteoarthritis, magnetic resonance imaging, bone marrow edema, histology, pain, and subchondral. Results BMLs in association with OA correspond to fibrosis, necrosis, edema, and bleeding of fatty marrow as well as abnormal trabeculae on histopathology. Lesions may fluctuate in size within a short time and are associated with the progression of articular cartilage loss and fluctuation of pain in knee OA. The characteristic subchondral edema-like signal intensity of BMLs should be assessed using T2-weighted, proton density-weighted, intermediate-weighted fat-suppressed fast spin echo or short tau inversion recovery. Several semiquantitative scoring systems are available to characterize and grade the severity of BMLs. Quantitative approaches have also been introduced. Differential diagnoses of degenerative BMLs include a variety of traumatic or nontraumatic pathologies that may appear similar to OA-related BMLs on MRI. Conclusions Subchondral BMLs are a common imaging feature of OA with clinical significance and typical signal alteration patterns, which can be assessed and graded by semiquantitative scoring systems using sensitive MRI sequences.

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Section: Resultsmentioning

confidence: 99%

Magnetic Resonance Imaging of Subchondral Bone Marrow Lesions in Association with Osteoarthritis

Hayashi

Roemer

et al. 2012

Seminars in Arthritis and Rheumatism

100

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“…BME associated with overuse or trauma (Fig. 2 ) usually resolves after a few months (usually 3 months); however, the clinical symptoms disappear sooner, usually after 6 weeks [ 6 , 8 , 9 ]. Sometimes it may take longer for the BME to resolve [ 1 ].…”

Section: Bone Marrow Edema After Overuse Minor or Major Traumamentioning

confidence: 99%

“…By firstly determining if there is BME on only one side of the ankle joint or it is multifocal and secondly the type of BME, the BME pattern can reveal the mechanism of injury [ 1 , 9 ]. The absence of a hypointense line on T1-weighted images excludes a complete fracture which needs a different treatment (Fig.…”

Section: Bone Marrow Edema After Overuse Minor or Major Traumamentioning

confidence: 99%

Traumatic and non-traumatic bone marrow edema in ankle MRI: a pictorial essay

2020

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Bone marrow edema (BME) is one of the most common findings on magnetic resonance imaging (MRI) after an ankle injury but can be present even without a history of trauma. This article will provide a systematic overview of the most common disorders in the ankle and foot associated with BME. The presence of BME is an unspecific but sensitive sign of primary pathology and may act as a guide to correct and systematic interpretation of the MR examination. The distribution of BME allows for a determination of the trauma mechanism and a correct assessment of soft tissue injury. The BME pattern following an inversion injury involves the lateral malleolus, the medial part of the talar body, and the medial part of the distal tibia. In other cases, a consideration of the distribution of BME may indicate the mechanism of injury or impingement. Bone in direct contact with a tendon may lead to alterations in the bone marrow signal where BME may indicate tendinopathy or dynamic tendon dysfunction. Changed mechanical forces between bones in coalition may lead to BME. Degenerative changes or minor cartilage damage may lead to subchondral BME. Early avascular necrosis, inflammation, or stress fracture may lead to more diffuse BME; therefore, a detailed medical history is crucial for correct diagnosis. A systematic analysis of BME on MRI can help to determine the trauma mechanism and thus assess soft tissue injuries and help to differentiate between different etiologies of nontraumatic BME.

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“…A bone marrow edema-like signal on the ankle and foot MRI is often related to non-traumatic causes such as inflammation or infection [6]. For example, a bone marrow edema-like signal representing osteitis is frequently seen in a setting of inflammatory, degenerative, or crystalinduced arthropathy, particularly gout, and may be quite extensive during disease exacerbation ( Figure 3).…”

Section: E534mentioning

confidence: 99%

Magnetic resonance imaging of the ankle and foot

Gorbachova¹

2020

Pol J Radiol

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This article reviews the magnetic resonance imaging (MRI) findings of the normal anatomy and various pathologic conditions of the ankle and foot commonly encountered in clinical practice. The spectrum of entities discussed includes osseous and osteochondral injuries, ligamentous injuries, common traumatic and degenerative tendon pathology, abnormalities of transverse tarsal joint (Chopart) and tarsometatarsal joint (Lisfranc) complexes, pathological conditions affecting capsuloligamentous structures of the great toe and lesser toes, as well as pedal infection, with a focus on diabetic osteomyelitis and neuropathic osteoarthropathy.

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Bone Marrow Edema Patterns in the Ankle and Hindfoot: Distinguishing MRI Features

Abstract: After review of this article, radiologists should be able to use their knowledge of clinical history and specific MRI patterns and locations to accurately distinguish between the various causes of bone marrow edema in the ankle and hindfoot.

Cited by 55 publications

References 15 publications

Magnetic Resonance Imaging of Subchondral Bone Marrow Lesions in Association with Osteoarthritis

Magnetic Resonance Imaging of Subchondral Bone Marrow Lesions in Association with Osteoarthritis

Traumatic and non-traumatic bone marrow edema in ankle MRI: a pictorial essay

Magnetic resonance imaging of the ankle and foot

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