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Bone Marrow Oedema in the Knees of Asymptomatic High-Level Athletes: Prevalence and Associated Factors



Bone marrow oedema (BMO), seen on magnetic resonance imaging, can be associated with various injuries to the knee but may also occur in asymptomatic athletes. The prevalence and causal factors for these observations are not well understood. The aim of this study was to determine the prevalence of BMO in asymptomatic knees of athletes, competing at a high level, and to investigate the associated factors.

Materials and Methods

Twenty-five asymptomatic university athletes, competing at regional to international level, were recruited. Bilateral knee magnetic resonance imaging was performed in each athlete (total 50 knee scans) at the end of their competitive season. Imaging studies were reported independently by two experienced consultant musculoskeletal radiologists.


There was almost perfect agreement between reporters for diagnosis of BMO (κ = 0.896). Seven participants (28%) were found to have BMO (six in one knee and one bilaterally). The amount of time spent training, during the season, was significantly associated with the appearance of BMO (p < 0.05).


The occurrence of BMO in asymptomatic knees of athletes is common (occurring in over one-quarter of knees) and may be associated with training intensity. This should be considered when treating athletes and deciding upon appropriate treatment plans.

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Authors and Affiliations



This submission represents honest and significant work from all authors. KB, VM, CW and PS conceived the idea for the study. VM, KB and RP designed the protocol. AR and DS performed the radiological assessment. JK, VM and RP were involved in the analysis and interpretation of the results. VM and JK wrote the first draft. All authors were involved in the editing of the manuscript and gave approval to the final draft.

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Correspondence to Jonathan Kosy.

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Ethical standard statement

This article does not contain any studies with human or animal subjects performed by the any of the authors.

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The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Mandalia, V., Williams, C., Kosy, J. et al. Bone Marrow Oedema in the Knees of Asymptomatic High-Level Athletes: Prevalence and Associated Factors. JOIO 54, 324–331 (2020).

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  • Bone marrow oedema
  • Magnetic resonance imaging
  • Asymptomatic
  • Athletes