What is bone marrow edema?

Bone marrow edema, also referred to as a bone marrow lesion, is the build-up of fluid within the bone marrow. Typically this accumulation of fluid is due a an injury to the bones or develops over time due to worsening osteoarthritis.  

How does one develop A bone marrow edema?

Bone marrow edema typically develops from injury or osteoarthritis. Bone marrow consists of fatty, bony, and blood cell producing material and is contained within what is called the “spongy bone”. When edema occurs, the increased fluid inside the bone causes inflammation of the bone marrow and adjacent joint.

The most common causes of bone marrow edema are:

  • Arthritis: In patients with osteoarthritis, the development of bone marrow edema is indicative of a declining condition. In osteoarthritis patients, subchondral cysts are often seen on an MRI as well. This is the result of cartilage beginning to harden and form cysts within the joint. Cysts cause the joint space to narrow and the cartilage wear away
  • Stress Fractures or ligament injuries: Stress fractures occur from repetitive stress on the bone. Due to physical activities such as running, dancing, or weightlifting, stress fractures are characterized by bone edema and fracture lines. Ligament injuries often arise from overuse or acute injury such as an Anterior Cruciate Ligament tear (ACL tear).
  • Cancer: Bone tumors can cause increased water production within bones. Radiation cancer treatment can also cause bone marrow edema or bone marrow lesions.
  • Infection: Bone infections can cause excess water production in bone. Typically, the resulting edema will resolve itself after the infection is treated.

The most common areas for bone marrow edema to occur are:

Bone marrow edema of the hip

Bone marrow edema of the knee

Bone marrow edema of the ankle/foot

Bone marrow edema of the shoulder

Bone marrow edema of the spine

Bone marrow edema of the hip

 

 What are the symptoms of bone marrow edemas?

Patients with bone marrow edema primarily exhibit pain in the affected bone or complain about dysfunction such as lack of range of motion in the affected joint or bone. This reduction in range of motion is caused by the accumulation of fluid and in turn is a primary pain source. Many patients however may not even know they have bone marrow edema due to a lack of symptoms.

How are bone marrow edema diagnosed?

Bone marrow edemas are diagnosed using imaging such as MRI or Ultrasound, they are not seen on CT’s or X-Rays. Bone marrow edemas or bone lesions are typically found while examining another condition or pain source in or around the bone.

How are bone marrow edemas treated?

In the vast majority of cases, bone marrow edemas resolve with time, rehab, and anti-inflammatory medications.

Surgery may be required in more serious cases of bone marrow edemas. A core decompression is a common procedure for bone marrow edemas or lesions. In a Core Decompression surgery, holes are drilled into the bone and then filled with bone graft material or bone marrow stem cells. This stimulates normal bone marrow growth.

If you suspect you may have a  bone marrow edema, call 817-375-5200  to schedule an appointment with AOA Orthopedic Specialists!