Primary bone marrow oedema syndromes

Abstract

MRI scanning in patients with rheumatological conditions often shows bone marrow oedema, which can be secondary to inflammatory, degenerative, infective or malignant conditions but can also be primary. The latter condition is of uncertain aetiology and it is also uncertain whether it represents a stage in the progression to osteonecrosis in some patients. Patients with primary bone marrow oedema usually have lower limb pain, commonly the hip, knee, ankle or feet. The diagnosis is one of exclusion with the presence of typical MRI findings. Treatment is usually conservative and includes analgesics and staying off the affected limb. The natural history is that of gradual resolution of symptoms over a number of months. Evidence for medical treatment is limited, but open-label studies suggest bisphosphonates may help in the resolution of pain and improve radiological findings. Surgical decompression is usually used as a last resort.

Osteonecrosis of the femoral head: diagnosis and classification systems

“…The characteristic MRI finding is widespread marrow edema throughout the proximal femur including femoral head, neck, and trochanteric region, whereas ON is usually located focally in the femoral head or subchondral region. Plain radiographs are frequently unremarkable except relative osteopenia [51][52][53]. A bone scan shows marked, diffuse increased uptake throughout the entire femoral head and neck region.…”

MR imaging of transient osteoporosis of the hip: An update on 155 hip joints

“…BMe can be classified into two broad categories: reversible with conservative treatment, such as transient osteoporosis of the hip (TOH), regional migratory osteoporosis (RMO), chronic regional pain syndrome (CRPS), trauma -including stress injuries and insufficiency fractures -and non-reversible, such as avascular necrosis (AVN), infection, tumors, and degenerative and inflammatory arthropathy [1][2][3][4][5][6][7].…”

En mann i 40-årene med smerter i høyre lår og kne

“…Smertene og påvisningen av lav bentetthet i det affiserte området var forenlige med tilstanden benmargsødemsyndrom (8). …”