Bone Marrow Edema Syndrome of the Medial Femoral Condyle Treated With Extracorporeal Shock Wave Therapy: A Clinical and MRI Retrospective Comparative Study

Vitali, Matteo; Rodriguez, Nadim Naim; Pedretti, Alberto; Drossinos, Andreas; Pironti, Pierluigi; Carlo, Gaia Di; Fraschini, G.

doi:10.1016/j.apmr.2017.10.025

Cited by 20 publications

(22 citation statements)

References 24 publications

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“…(BMES, migrating BMES, transient BMES, transitory BMES, transient osteoporosis or primary BME are interchangeable terms for the same entity of BME [48,[103][104][105][106][107]. All refer to a temporary (transient) painful BME, without any evidence of focal osteonecrosis or a specific underlying pathology [48,106]. Therefore, the LMU Consensus Group recommends that the term BMES be used only for a painful BME without an identifiable underlying cause according our diagnostic algorithm.…”

Section: Bone Marrow Edema Syndrome (Bmes)mentioning

confidence: 99%

“…The primary aim of treating BMES is a quick reduction of pain and disability, as well as dissolution of the BME [106]. Usually, BMES is considered self-limiting over 3 to 18 months [24,106]. Measures to shorten this natural history should initially be partial weight-bearing, immobilization, analgesics and anti-inflammatory medication.…”

Section: Bone Marrow Edema Syndrome (Bmes)mentioning

confidence: 99%

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How We Manage Bone Marrow Edema—An Interdisciplinary Approach

Baumbach

Pfahler

Pozza

et al. 2020

JCM

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Bone marrow edema (BME) is a descriptive term for a common finding in magnetic resonance imaging (MRI). Although pain is the major symptom, BME differs in terms of its causal mechanisms, underlying disease, as well as treatment and prognosis. This complexity together with the lack of evidence-based guidelines, frequently makes the identification of underlying conditions and its management a major challenge. Unnecessary multiple consultations and delays in diagnosis as well as therapy indicate a need for interdisciplinary clinical recommendations. Therefore, an interdisciplinary task force was set up within our large osteology center consisting of specialists from internal medicine, endocrinology/diabetology, hematology/oncology, orthopedics, pediatrics, physical medicine, radiology, rheumatology, and trauma surgery to develop a consenus paper. After review of literature, review of practical experiences (expert opinion), and determination of consensus findings, an overview and an algorithm were developed with concise summaries of relevant aspects of the respective underlying disease including diagnostic measures, clinical features, differential diagnosis and treatment of BME. Together, our single-center consensus review on the management of BME may help improve the quality of care for these patients.

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Section: Bone Marrow Edema Syndrome (Bmes)mentioning

confidence: 99%

Section: Bone Marrow Edema Syndrome (Bmes)mentioning

confidence: 99%

How We Manage Bone Marrow Edema—An Interdisciplinary Approach

Baumbach

Pfahler

Pozza

et al. 2020

JCM

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“…Begriffe wie transiente Osteoporose, transientes Knochenmarködem-Syndrom, Osteoporosis migrans/saltans oder lokale Osteoporose wurden als Synonyme für das KMÖS verwendet, sollten aber in diesem Zusammenhang vermieden werden, um eine einheitliche Nomenklatur zu etablieren [5][6][7][8][9]. Alle bezeichnen ein vorübergehendes schmerzhaftes KMÖ ohne Anzeichen einer fokalen Osteonekrose oder einer diagnostizierbaren Pathologie [5,43]. Daher handelt es sich bei dem KMÖS um eine Ausschlussdiagnose.…”

Section: Das Schmerzhafte Knochenmarködem-syndromunclassified

Das Knochenmarködem-Syndrom: interdisziplinäre Diagnosestrategie und Therapieoptionen

et al. 2021

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ZusammenfassungDas Knochenmarködem (KMÖ) ist ein häufiger, rein deskriptiver Befund in der Magnetresonanztomographie (MRT). Schmerz ist das klinische Hauptsymptom. Knochenmarködeme unterscheiden sich wesentlich in Ursache, zugrundeliegender Erkrankung sowie in Therapie, Verlauf und Prognose. Diese Komplexität macht, zusammen mit dem Fehlen evidenzbasierter Leitlinien, die Identifizierung der Ursachen und deren Therapie zu einer großen Herausforderung. Ein interdisziplinärer Arbeitskreis des osteologischen Schwerpunktzentrums des LMU Klinikums hat ein KMÖ-Konsensuspapier erbarbeitet und publiziert [4]. Hier sollen die Ergebnisse mit einem Schwerpunkt auf das schmerzhafte KMÖ-Syndrom (KMÖS) präsentiert werden. In unserer klinischen Erfahrung kommt es zu deutlichen Verzögerungen bei Diagnose sowie Therapie, deshalb besteht nach wie vor die Notwendigkeit von interdisziplinären klinischen Empfehlungen. In der hier vorliegenden Arbeit ist nun eine Überarbeitung des Konsensuspapiers [4] mit Fokus auf dem Aspekt des schmerzhaften Knochenmarködem-Syndroms erfolgt. Aus erneuter Literaturrecherche, Überprüfung klinischer Erfahrungen (Expertenmeinung) und der ergebnisorientierten Überarbeitung des LMU-Konsenuspapiers wurde eine Zusammenfassung mit diagnostischen Maßnahmen, Differenzialdiagnosen und Therapieoptionen beim KMÖS erstellt. Ziel ist eine stratifizierte, klinische Herangehensweise hinsichtlich weiterführender Diagnostik und auch Therapie bei Vorliegen eines schmerzhaften KMÖS.

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“…ESWT has been used safely for augmentation of wound healing of bone and muscle and promotes alveolar bone regeneration, neovascularization, distraction osteogenesis and stem cell differentiation in rats [ 12 – 15 ]. ESWT has been used increasingly in healing of several refractory musculoskeletal disorders [ 16 – 18 ] yet its biologic mechanism is not well understood [ 12 , 13 ]. Recently ESWT has been reported to induce interleukin-1β (IL-1β), a potent cytokine for bone resorption, during 3 days of tooth movement in rats and no long-term observation was studied [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal shockwave treatment impedes tooth movement in rats

Atsawasuwan¹,

Chen²,

Ganjawalla³

et al. 2018

Head Face Med

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BackgroundAccelerated tooth movement has been a topic of interest for orthodontic research recently. Surgically facilitated orthodontic treatment has been shown to be an effective approach to accelerate tooth movement; however, it remains invasive, requires additional surgery, and may increase post-operative complications. In this study, we evaluate the effects of extracorporeal shockwave treatment (ESWT), a non-invasive approach to regenerate alveolar bone, on orthodontic tooth movement in rats.Materials and methodsSeventy-two male rats, aged 10 weeks old, were subjected to 10-cN closed-coil nickel-titanium springs for unilateral maxillary first molar tooth movement. One group of rats received a single treatment of extracorporeal shockwave treatment at 500 impulses at energy flux density 0.1 mJ/mm2, with a pulse rate of 5 pulses per second immediately after spring installation while the non-ESWT-treated group served as a control group. The rats were sacrificed at day 3, 7, 14, 21 and 28 for tooth movement evaluation and sample analyses. Faxitron radiography, histological, double bone labeling and gene expression analyses were performed. Serum biochemistry was evaluated at day 3, 7 and 28 of the study. Kruskal-Wallis analysis of variance was used to determine the mean difference among groups, and multiple comparisons were analyzed by Mann-Whitney-U tests with a significance level = 0.05.ResultsThe results demonstrated that tooth movement in the ESWT-treated rats (0.11 ± 0.07 mm) was impeded compared to the tooth movement in the non-ESWT-treated rats (0.44 ± 0.09 mm). ESWT up-regulated several osteoblastic and osteoclastic gene markers and cytokines; however, the effects on osteoclasts were only transient. Double-fluorescence bone labeling demonstrated that osteoblastic activity increased after ESWT treatment. There was no difference in systemic RANKL/OPG ratio between groups.ConclusionsESWT at 500 impulse at energy flux density 0.1 mJ/mm2 increased osteoblast and osteoclast activities and imbalanced bone remodeling resulting in impeded tooth movement in rats.

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Bone Marrow Edema Syndrome of the Medial Femoral Condyle Treated With Extracorporeal Shock Wave Therapy: A Clinical and MRI Retrospective Comparative Study

Cited by 20 publications

References 24 publications

How We Manage Bone Marrow Edema—An Interdisciplinary Approach

How We Manage Bone Marrow Edema—An Interdisciplinary Approach

Das Knochenmarködem-Syndrom: interdisziplinäre Diagnosestrategie und Therapieoptionen

Extracorporeal shockwave treatment impedes tooth movement in rats

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