Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy

Abstract

Ultrasound diathermy is widely used for the treatment of musculoskeletal disorders and other soft tissue injuries. Its use as a therapeutic modality is believed to be safe, with very few reported complications. Here, we report two patients who developed focal bone marrow abnormalities after receiving ultrasound diathermy. Both patients’ magnetic resonance (MR) evaluations revealed linear subchondral bone lesions of the superolateral humeral head similar to those in osteonecrosis. The patients’ symptoms subsequently improved, and available follow-up MR evaluation revealed near complete resolution of bone lesions. These findings suggest that ultrasound diathermy, and its interaction with bone tissue through thermal mechanisms, can cause focal bone marrow abnormalities. Furthermore, the bone marrow abnormalities seem to be transient, resolving upon cessation of ultrasound diathermy, therefore osteonecrosis should be differentiated from this temporal lesion.

MRI Bone Abnormality of the Knee following Ultrasound Therapy: Case Report and Short Review

“…In the same way, in their two patients treated with US, Seung Jae J. Kim et al described diathermy-associated focal bone marrow abnormalities of the superolateral humeral head [ 64 ]. They concluded that the timing and transient nature of the findings in relation to the diathermy procedures suggest that US diathermy was the cause of these focal bone marrow lesions.…”