Treatment of Bone Marrow Lesions (bone Marrow Edema)

Overview

Journal Bonekey Rep

Date 2015 Dec 9

PMID 26644910

Citations 28

Authors

Erik F Eriksen

Affiliations

Soon will be listed here.

Abstract

Bone marrow lesions (BMLs) or using older terminology 'Bone marrow edema' is characterised by excessive water signals in the marrow space on magnetic resonance imaging or ultrasound; BMLs constitute a central component of a wide variety of inflammatory and non-inflammatory rheumatologic conditions affecting the musculoskeletal system: BMLs are not only considered significant sources of pain but also linked to increased disease activity in many musculoskeletal conditions (for example, osteoarthritis, rheumatoid arthritis). The purpose of this review is to summarise current knowledge about the treatment of BMLs, with an emphasis on the clinical and histological features of this entity in inflammatory and non-inflammatory disease. We also try to pair this hypothesis with the apparent beneficial effects of various treatment regimens, mainly within the group of bone antiresorptive drugs (calcitonin, bisphosphonates) on symptoms associated with BMLs.

Citing Articles

The relationship between MRI-detected hip abnormalities and hip pain in hip osteoarthritis: a systematic review.

Fang H, Zhang X, Wang J, Xing X, Shen Z, Cai G Rheumatol Int. 2024; 44(10):1887-1896.

PMID: 39136786 PMC: 11393093. DOI: 10.1007/s00296-024-05678-2.

No Significant Differences between Bisphosphonates and Placebo for the Treatment of Bone Marrow Lesions of the Knee: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Anzillotti G, Ottl F, Franceschi C, Conte P, Bertolino E, Lipina M J Clin Med. 2024; 13(13).

PMID: 38999364 PMC: 11242668. DOI: 10.3390/jcm13133799.

Bone marrow lesions in osteoarthritis: biomarker or treatment target? A narrative review.

Ge L, Zhang X, Zhu R, Cai G Skeletal Radiol. 2024; 54(2):175-191.

PMID: 38877110 DOI: 10.1007/s00256-024-04725-0.

Preoperative patellar bone marrow lesions with full thickness cartilage defects correlate with residual anterior knee pain in total knee arthroplasty without patellar resurfacing.

Jung H, Kang M, Lee J, Lee J, Kim J Knee Surg Sports Traumatol Arthrosc. 2023; 31(11):5048-5056.

PMID: 37695390 DOI: 10.1007/s00167-023-07551-4.

Bone marrow lesions of the femoral head: can radiomics distinguish whether it is reversible?.

Batur H, Mendi B, Cay N Pol J Radiol. 2023; 88:e194-e202.

PMID: 37234462 PMC: 10207319. DOI: 10.5114/pjr.2023.127055.

References

Majumdar S, Issever A, Burghardt A, Lotz J, Arfelli F, Rigon L . Diffraction enhanced imaging of articular cartilage and comparison with micro-computed tomography of the underlying bone structure. Eur Radiol. 2004; 14(8):1440-8. DOI: 10.1007/s00330-004-2355-8. View

Bennell K, Creaby M, Wrigley T, Bowles K, Hinman R, Cicuttini F . Bone marrow lesions are related to dynamic knee loading in medial knee osteoarthritis. Ann Rheum Dis. 2009; 69(6):1151-4. DOI: 10.1136/ard.2009.118182. View

Russell R, Watts N, Ebetino F, Rogers M . Mechanisms of action of bisphosphonates: similarities and differences and their potential influence on clinical efficacy. Osteoporos Int. 2008; 19(6):733-59. DOI: 10.1007/s00198-007-0540-8. View

Radke S, Rader C, Kenn W, Kirschner S, Walther M, Eulert J . Transient marrow edema syndrome of the hip: results after core decompression. A prospective MRI-controlled study in 22 patients. Arch Orthop Trauma Surg. 2003; 123(5):223-7. DOI: 10.1007/s00402-003-0506-z. View

Beckmann J, Schmidt T, Schaumburger J, Rath B, Luring C, Tingart M . Infusion, core decompression, or infusion following core decompression in the treatment of bone edema syndrome and early avascular osteonecrosis of the femoral head. Rheumatol Int. 2012; 33(6):1561-5. DOI: 10.1007/s00296-012-2597-8. View

Tas F, Duranyildiz D, Oguz H, Camlica H, Yasasever V, Topuz E . Effect of zoledronic acid on serum angiogenic factors in patients with bone metastases. Med Oncol. 2008; 25(3):346-9. DOI: 10.1007/s12032-008-9043-5. View

Jager M, Tillmann F, Thornhill T, Mahmoudi M, Blondin D, Hetzel G . Rationale for prostaglandin I2 in bone marrow oedema--from theory to application. Arthritis Res Ther. 2008; 10(5):R120. PMC: 2592809. DOI: 10.1186/ar2526. View

Aigner N, Petje G, Schneider W, Meizer R, Wlk M, Kotsaris S . Bone marrow edema syndrome of the femoral head: treatment with the prostacyclin analogue iloprost vs. core decompression: an MRI-controlled study. Wien Klin Wochenschr. 2005; 117(4):130-5. DOI: 10.1007/s00508-005-321-3. View

Gangji V, Hauzeur J, Matos C, De Maertelaer V, Toungouz M, Lambermont M . Treatment of osteonecrosis of the femoral head with implantation of autologous bone-marrow cells. A pilot study. J Bone Joint Surg Am. 2004; 86(6):1153-60. DOI: 10.2106/00004623-200406000-00006. View

10.

Roemer F, Guermazi A, Lynch J, Peterfy C, Nevitt M, Webb N . Short tau inversion recovery and proton density-weighted fat suppressed sequences for the evaluation of osteoarthritis of the knee with a 1.0 T dedicated extremity MRI: development of a time-efficient sequence protocol. Eur Radiol. 2005; 15(5):978-87. DOI: 10.1007/s00330-004-2608-6. View

11.

Schett G . Bone marrow edema. Ann N Y Acad Sci. 2009; 1154:35-40. DOI: 10.1111/j.1749-6632.2009.04383.x. View

12.

Simon M, Barvencik F, Luttke M, Amling M, Mueller-Wohlfahrt H, Ueblacker P . Intravenous bisphosphonates and vitamin D in the treatment of bone marrow oedema in professional athletes. Injury. 2014; 45(6):981-7. DOI: 10.1016/j.injury.2014.01.023. View

13.

Wang C, Huang C, Wang J, Wong T, Yang Y . Long-term results of extracorporeal shockwave therapy and core decompression in osteonecrosis of the femoral head with eight- to nine-year follow-up. Biomed J. 2013; 35(6):481-5. DOI: 10.4103/2319-4170.104413. View

14.

Evangelisto A, Wakefield R, Emery P . Imaging in early arthritis. Best Pract Res Clin Rheumatol. 2004; 18(6):927-43. DOI: 10.1016/j.berh.2004.07.002. View

15.

Crozier F, Champsaur P, Pham T, Bartoli J, Kasbarian M, Chagnaud C . Magnetic resonance imaging in reflex sympathetic dystrophy syndrome of the foot. Joint Bone Spine. 2003; 70(6):503-8. DOI: 10.1016/s1297-319x(03)00142-8. View

16.

Berger C, Kroner A, Minai-Pour M, Ogris E, Engel A . Biochemical markers of bone metabolism in bone marrow edema syndrome of the hip. Bone. 2003; 33(3):346-51. DOI: 10.1016/s8756-3282(03)00164-9. View

17.

Erdem C, Solak Tekin N, Sarikaya S, Erdem L, Gulec S . MR imaging features of foot involvement in patients with psoriasis. Eur J Radiol. 2007; 67(3):521-5. DOI: 10.1016/j.ejrad.2007.08.005. View

18.

Starr A, Wessely M, Albastaki U, Pierre-Jerome C, Kettner N . Bone marrow edema: pathophysiology, differential diagnosis, and imaging. Acta Radiol. 2008; 49(7):771-86. DOI: 10.1080/02841850802161023. View

19.

Manicourt D, Brasseur J, Boutsen Y, Depreseux G, Devogelaer J . Role of alendronate in therapy for posttraumatic complex regional pain syndrome type I of the lower extremity. Arthritis Rheum. 2004; 50(11):3690-7. DOI: 10.1002/art.20591. View

20.

Carter J, Kedar R, Anderson S, Osorio A, Albritton N, Gnanashanmugam S . An analysis of MRI and ultrasound imaging in patients with gout who have normal plain radiographs. Rheumatology (Oxford). 2009; 48(11):1442-6. DOI: 10.1093/rheumatology/kep278. View