Bone Marrow Edema
Andreas Leonidou
Orthopaedic Surgeon
Λεωφ. Κηφισίας 56 & Δελφών,
Μαρούσι, 15125
- Symptoms
- Conservative Treatment
- Surgical Treatment
- Surgical Treatment
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Bone marrow edema or bone marrow oedema is a condition characterised by inflammation and swelling (fluid) within the bone marrow. It can be caused by various factors, such as injury, exercise, and chronic conditions, including osteoarthritis. Symptoms of bone marrow edema include pain, swelling, tenderness, and stiffness. The diagnosis of bone marrow edema is usually made with the help of magnetic resonance imaging (MRI). Treatment of bone marrow edema usually includes rest, ice, medication, and physiotherapy. Prevention of bone marrow edema is important and includes avoiding injuries, exercising in moderation, and treating any chronic conditions.
Bone Marrow Edema – Causes
The main cause of bone marrow edema is continuous and repetitive stress on the joint. Bone marrow edema can be caused by various factors, such as:
Trauma: Bone marrow edema may occur after an injury to the joint.
Exercise: Intense exercise, especially in sports involving jumping or running, may cause bone marrow edema.
Chronic conditions: Osteoarthritis, rheumatoid arthritis, and other chronic conditions affecting the joints can cause bone marrow edema.
Infections: A bone infection, such as osteomyelitis.
Osteonecrosis (avascular necrosis – AVN).
Patients with hormonal disorders, vitamin D deficiency, or calcium deficiency are more prone to bone marrow edema.
People with a sedentary lifestyle and no physical activity may develop bone marrow edema more easily, even after low-intensity activity.
Bone Marrow Edema – Symptoms
Symptoms of bone marrow edema include:
Severe pain during exercise as well as at rest
Swelling of the soft tissues around the bone
Tenderness on palpation
Joint stiffness
Difficulty walking when the condition affects the lower limbs
Bone Marrow Edema – Diagnosis
A patient with suspected bone marrow edema requires a clinical examination by an Orthopaedic Surgeon. Dr Leonidou will take a detailed medical history and examine you. The doctor may perform an ultrasound scan and will discuss the recommended treatment options with you. Further examinations will be required, such as plain X-rays to rule out a fracture and magnetic resonance imaging (MRI) to confirm the diagnosis and assess severity.
Bone Marrow Edema – Treatment
Treatment of bone marrow edema usually includes rest, ice, medication, and physiotherapy.
Rest: Rest is important to allow the bone to heal. For lower limb conditions, unloading with crutches is required for a certain period of time.
Ice therapy: The use of ice helps reduce pain and swelling. Apply ice to the affected area for 10 to 15 minutes every 3–4 hours during the day.
Medication: Simple painkillers and non-steroidal anti-inflammatory drugs.
Physiotherapy: An individualised physiotherapy programme helps restore range of motion and strengthen the joint. With the use of specialised equipment, bone marrow edema heals faster.
Proper nutrition and calcium or vitamin D supplements when indicated.
Knee Bone Marrow Edema – Surgical Repair
If conservative treatment fails in cases of knee bone marrow edema, minimally invasive repair with subchondroplasty is available. It is a minimally invasive procedure in which the area of bone marrow edema (subchondral bone) is filled with a material that repairs the damage, removes the edema, and is gradually absorbed and replaced by new bone. Subchondroplasty does not require hospitalisation and can be performed alone or in combination with knee arthroscopy.
Preoperatively, the lesion is mapped with the assistance of MRI and then repaired through injection of the specialised material, resulting in resolution of the problem.
What Can You Do to Prevent Bone Marrow Edema?
Prevention of bone marrow edema includes:
Avoiding injuries: The risk of injury can be reduced by using appropriate equipment (such as footwear) during exercise and by proper warm-up and technique.
Exercising in moderation: Excessive and sudden exercise can increase the risk of bone marrow edema. It is important to gradually increase the duration and intensity of exercise.
Timely and effective treatment of any chronic conditions affecting the joints can help prevent bone marrow edema.
Proper and balanced nutrition.
Incorporating physical exercise into our daily routine.
Bone Marrow Edema – Recovery and Return to Sports
The time required for full recovery varies depending on the severity of the edema and the affected bone. Return to sports activities is recommended once symptoms have completely subsided, with a gradual increase in intensity and frequency.
Bone marrow edema is a condition that can cause pain, stiffness, and reduced mobility. However, early diagnosis and treatment can help achieve faster recovery. If you have bone marrow edema, consult the specialised Orthopaedic Surgeon Dr Andreas Leonidou immediately. For more information and appointments, please contact us.
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