Lower Limb Pain Attributed to Bone Marrow Edema Syndrome: A Commonly Ignored Pathology

Balfousias, Theodore; Karadimas, Efthimios J.; Kakagia, Despoina; Apostolopoulos, Alexandros P; Papanikolaou, Athanasios

doi:10.7759/cureus.7679

Cited by 1 publication

(1 citation statement)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Transient BMES is a rare but reversible condition characterized by pain and bone marrow edema-like signal intensity on MRI. Various terms have been used to describe this condition, including transient osteoporosis or regional migratory osteoporosis when it migrates to a different joint or within the same joint over several months [77][78][79]. Although transient BMES is much rarer than SIFK, it may be overlooked because of its self-limited nature.…”

Section: Transient Bone Marrow Edema Syndromementioning

confidence: 99%

Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses

et al. 2021

View full text Add to dashboard Cite

Subchondral insufficiency fracture of the knee (SIFK) is a common cause of knee joint pain in older adults. SIFK is a type of stress fracture that occurs when repetitive and excessive stress is applied to the subchondral bone. If the fracture does not heal, the lesion develops into osteonecrosis and results in osteochondral collapse, requiring surgical management. Because of these clinical features, SIFK was initially termed “spontaneous osteonecrosis of the knee (SONK)” in the pre-MRI era. SONK is now categorized as an advanced SIFK lesion in the spectrum of this disease, and some authors believe the term “SONK” is a misnomer. MRI plays a significant role in the early diagnosis of SIFK. A subchondral T2 hypointense line of the affected condyle with extended bone marrow edema-like signal intensity are characteristic findings on MRI. The large lesion size and the presence of osteochondral collapse on imaging are associated with an increased risk of osteoarthritis. However, bone marrow edema-like signal intensity and osteochondral collapse alone are not specific to SIFK, and other osteochondral lesions, including avascular necrosis, osteochondral dissecans, and osteoarthritis should be considered. Chondral lesions and meniscal abnormalities, including posterior root tears, are also found in many patients with SIFK, and they are considered to be related to the development of SIFK. We review the clinical and imaging findings, including the anatomy and terminology history of SIFK, as well as its differential diagnoses. Radiologists should be familiar with these imaging features and clinical presentations for appropriate management.

show abstract

Section: Transient Bone Marrow Edema Syndromementioning

confidence: 99%