Bone Marrow Edema Pattern

  • Lia Angela MoulopoulosEmail author
  • Vassilis Koutoulidis


The regional bone marrow pattern, as already discussed in  Chap. 4, is further divided into hyperintense and hypointense regional bone marrow pattern. The former is related to prior radiation therapy and is discussed in  Chap. 8. The latter is due to bone marrow edema of various causes. Marrow edema associated with tumors and inflammatory/infectious diseases is beyond the scope of this book. Instead, in this chapter we will focus on the transient bone marrow edema syndrome which often presents a diagnostic challenge as it may lack characteristic associated findings suggestive of a specific diagnosis.


Bone Marrow Edema Complex Regional Pain Syndrome Bone Bruise Abnormal Signal Intensity Transient Osteoporosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Wilson AJ, Murphy WA, Hardy DC et al (1988) Transient osteoporosis: transient bone marrow edema? Radiology 167:757–760CrossRefPubMedGoogle Scholar
  2. 2.
    Vande Berg BC, Lecouvet FE, Koutaissoff S et al (2008) Bone marrow edema of the femoral head and transient osteoporosis of the hip. Eur J Radiol 67:68–77CrossRefPubMedGoogle Scholar
  3. 3.
    Vande Berg BC, Malghem JJ, Lecouvet FE et al (1999) Idiopathic bone marrow edema lesions of the femoral head: predictive value of MR imaging findings. Radiology 212:527–535CrossRefPubMedGoogle Scholar
  4. 4.
    Lakhanpal M, Ginsbury WW, Luthra HS et al (1987) Transient regional osteoporosis: a study of 56 cases and review of the literature. Ann Intern Med 106:444–450CrossRefPubMedGoogle Scholar
  5. 5.
    Curtiss PH Jr, Kincaid WE (1959) Transitory demineralization of the hip in pregnancy: a report of three cases. J Bone Joint Surg 41:1327–1333PubMedGoogle Scholar
  6. 6.
    Rozenbaum M, Zinman C, Nagler A et al (1984) Transient osteoporosis of the hip joint with liver cirrhosis. J Rheumatol 11:241–243PubMedGoogle Scholar
  7. 7.
    Pinals RS, Jabbs JM (1972) Type-IV hyperlipoproteinemia and transient osteoporosis. Lancet II:929CrossRefGoogle Scholar
  8. 8.
    Papadopoulos EC, Papagelopoulos PJ, Boscainos PJ et al (2001) Bone marrow edema syndrome. Orthopedics 24:69–73PubMedGoogle Scholar
  9. 9.
    Thiryayi WA, Thiryayi SA, Freemont AJ (2008) Histopathological perspective on bone marrow oedema, reactive bone change and haemorrhage. Eur J Radiol 67:62–67CrossRefPubMedGoogle Scholar
  10. 10.
    Eustace S, Keogh C, Blake M et al (2001) MR imaging of bone oedema: mechanisms and interpretation. Clin Radiol 56:4–12CrossRefPubMedGoogle Scholar
  11. 11.
    Koo KH, Jeong ST, Jones JP Jr (1999) Borderline necrosis of the femoral head. Clin Orthop 358:158–165CrossRefPubMedGoogle Scholar
  12. 12.
    Plenk H Jr, Hofmann S, Eschberger J et al (1997) Histomorphology and bone morphometry of the bone marrow edema syndrome of the hip. Clin Orthop Relat Res 334:73–84PubMedGoogle Scholar
  13. 13.
    Arlet J, Ficat P (1964) Forage-biopsie de la tête fémorale dans l’osteonécrose primitive. Observations histopathologiques portant sur huit forages. Rev Rhum Mal Osteoartic 31:257–264Google Scholar
  14. 14.
    Ficat RP (1985) Idiopathic bone necrosis of the femoral head: early diagnosis and treatment. J Bone Joint Surg Br 67:3–9PubMedGoogle Scholar
  15. 15.
    Crespo E, Sala D, Crespo R et al (2001) Transient osteoporosis. Acta Orthop Belg 67:330–337PubMedGoogle Scholar
  16. 16.
    Bray ST, Partain CL, Teates CD (1979) The value of the bone scan in idiopathic regional migratory osteoporosis. J Nucl Med 20:1268–1271PubMedGoogle Scholar
  17. 17.
    Bloem J (1988) Transient osteoporosis of the hip: MR imaging. Radiology 167:757–760CrossRefGoogle Scholar
  18. 18.
    Malizos KN, Zibis A, Dailiana Z et al (2004) MR imaging findings in transient osteoporosis of the hip. Eur J Radiol 50:238–244CrossRefPubMedGoogle Scholar
  19. 19.
    Korompilias AV, Karantanas AH, Lykissas MG (2009) Bone marrow edema syndrome. Skeletal Radiol 38:425–436CrossRefPubMedGoogle Scholar
  20. 20.
    Miyanishi K, Yamamoto T, Nakashima Y et al (2001) Subchondral changes in transient osteoporosis of the hip. Skeletal Radiol 30:255–261CrossRefPubMedGoogle Scholar
  21. 21.
    Assouline-Dayan Y, Chang C, Greenspan A et al (2002) Pathogenesis and natural history of osteonecrosis. Semin Arthritis Rheum 32:94–124CrossRefPubMedGoogle Scholar
  22. 22.
    Malizos KN, Karantanas AH, Sokratis E, Varitimidis SE et al (2007) Osteonecrosis of the femoral head: etiology, imaging and treatment. Eur J Radiol 63:16–28CrossRefPubMedGoogle Scholar
  23. 23.
    Kim YM, Oh HC, Kim HJ (2000) The pattern of bone marrow oedema on MRI in osteonecrosis of the femoral head. J Bone Joint Surg Br 82:837–841CrossRefPubMedGoogle Scholar
  24. 24.
    Mitchell DG, Rao VM, Dalinka MK et al (1987) Femoral head avascular necrosis: correlation of MR imaging, radiographic staging, radionuclide imaging, and clinical findings. Radiology 162:709–715CrossRefPubMedGoogle Scholar
  25. 25.
    Karantanas AH, Drakonaki E, Karachalios T et al (2008) Acute non-traumatic marrow edema syndrome in the knee: MRI findings at presentation, correlation with spinal DEXA and outcome. Eur J Radiol 67:22–33CrossRefPubMedGoogle Scholar
  26. 26.
    Ahlback S, Bauer GC, Bohne WH (1968) Spontaneous osteonecrosis of the knee. Arthritis Rheum 116:705–733CrossRefGoogle Scholar
  27. 27.
    Narvaez J, Narvaez JA, Rodriguez-Moreno J et al (2000) Osteonecrosis of the knee: differences among idiopathic and secondary types. Rheumatology 39:982–989CrossRefPubMedGoogle Scholar
  28. 28.
    Zanetti M, Bruder E, Romero J et al (2000) Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings. Radiology 215:835–840CrossRefPubMedGoogle Scholar
  29. 29.
    Kibbi L, Touma Z, Khoury N et al (2008) Oral bisphosphonates in treatment of transient osteoporosis. Clin Rheumatol 27:529–532CrossRefPubMedGoogle Scholar
  30. 30.
    Hofmann S, Engel A, Neuhold A (1993) Bone-marrow oedema syndrome and transient osteoporosis of the hip : An MRI-controlled study of treatment by core decompression. J Bone Joint Surg 75:210–216Google Scholar
  31. 31.
    Fingeroth RJ (1995) Successful operative treatment of a displaced subcapital fracture of the hip in transient osteoporosis of pregnancy. A case report and review of the literature. J Bone Joint Surg 77:127–131PubMedGoogle Scholar
  32. 32.
    Duncan H, Frame B, Frost H et al (1969) Regional migratory osteoporosis. South Med J 62:41–44CrossRefPubMedGoogle Scholar
  33. 33.
    Karantanas AH, Nikolakopoulos I, Korompilias AV et al (2008) Regional migratory osteoporosis in the knee: MRI findings in 22 patients and review of the literature. Eur J Radiol 67:34–41CrossRefPubMedGoogle Scholar
  34. 34.
    Trevisan C, Ortolani S (2002) Bone loss and recovery in regional migratory osteoporosis. Osteoporos Int 13:901–906CrossRefPubMedGoogle Scholar
  35. 35.
    Cahir JG, Toms AP (2008) Regional migratory osteoporosis. Eur J Radiol 67:2–10CrossRefPubMedGoogle Scholar
  36. 36.
    Trevisan C, Ortolani S, Monteleone M (2002) Regional migratory osteoporosis: a pathogenetic hypothesis based on three cases and a review of the literature. Clin Rheumatol 21:418–425CrossRefPubMedGoogle Scholar
  37. 37.
    De Mos M, De Bruijn AG, Huygen FJ et al (2006) The incidence of complex regional pain syndrome: a population-based study. Pain 1:12–20Google Scholar
  38. 38.
    Koch E, Hofer HO, Sialer G et al (1991) Failure of MR imaging to detect reflex sympathetic dystrophy of the extremities. Am J Roentgenol 156:113–115CrossRefGoogle Scholar
  39. 39.
    Fournier RS, Holder LE (1998) Reflex sympathetic dystrophy: diagnostic controversies. Semin Nucl Med 28:116–123CrossRefPubMedGoogle Scholar
  40. 40.
    Demangeat JL, Constantinesco A, Brunot B et al (1988) Three-phase bone scanning in reflex sympathetic dystrophy of the hand. J Nucl Med 29:26–32PubMedGoogle Scholar
  41. 41.
    Crozier F, Champsaur P, Pham T et al (2003) Magnetic resonance imaging in reflex sympathetic dystrophy syndrome of the foot. Joint Bone Spine 70:503–508CrossRefPubMedGoogle Scholar
  42. 42.
    Schweitzer M, Mandel S, Schwartzman RJ et al (1995) Reflex sympathetic dystrophy revisited: MR imaging before and after infusion of contrast material. Radiology 195:211–214CrossRefPubMedGoogle Scholar
  43. 43.
    Cappello ZJ, Kasdan ML, Louis DS (2012) Meta-analysis of imaging techniques for the diagnosis of complex regional pain syndrome type I. J Hand Surg Am 37:288–296CrossRefPubMedGoogle Scholar
  44. 44.
    Grotz WH, Breitenfeldt MK, Braune SW et al (2001) Calcineurin-inhibitor induced pain syndrome (CIPS): a severe disabling complication after organ transplantation. Transpl Int 14:16–23CrossRefPubMedGoogle Scholar
  45. 45.
    Maeshima K, Ishii K, Horita M et al (2008) Calcineurin-inhibitor induced pain syndrome (CIPS) in an adult-onset Still’s disease patient. Nippon Naika Gakkai Zasshi 97:2782–2788CrossRefPubMedGoogle Scholar
  46. 46.
    Kakihana K, Ohashi K, Murata Y et al (2012) Clinical features of calcineurin inhibitor-induced pain syndrome after allo-SCT. Bone Marrow Transplant 47:593–595CrossRefPubMedGoogle Scholar
  47. 47.
    Coates PT, Tie M, Russ GR et al (2002) Transient bone marrow edema in renal transplantation: a distinct bone marrow edema post-transplantation syndrome with a characteristic MRI appearance. Am J Transplant 2:467–470CrossRefPubMedGoogle Scholar
  48. 48.
    Chapin RW, Chua E, Simmons J et al (2013) Case report: imaging features in a renal transplant patient with calcineurin-inhibitor-induced pain syndrome (CIPS). Skeletal Radiol 42:1311–1315CrossRefPubMedGoogle Scholar
  49. 49.
    Mink JH, Reicher MA, Crues IH (eds) (1987) Magnetic resonance imaging of the knee. Raven, New YorkGoogle Scholar
  50. 50.
    Rangger C, Kathrein A, Freund MC et al (1998) Bone bruise of the knee: histology and cryosections in 5 cases. Acta Orthop Scand 69:291–294CrossRefPubMedGoogle Scholar
  51. 51.
    Johnson DL, Bealle DP, Brand JC et al (2000) The effect of a geographic lateral bone bruise on knee inflammation after acute anterior cruciate ligament rupture. Am J Sports Med 28:152–155PubMedGoogle Scholar
  52. 52.
    Lynch TCP, Crues JV, Morgan FW et al (1989) Bone abnormalities of the knee: prevalence and significance at MR imaging. Radiology 171:761–766CrossRefPubMedGoogle Scholar
  53. 53.
    Vincken PW, Ter Braak BP, van Erkel AR et al (2006) Clinical consequences of bone bruise around the knee. Eur Radiol 16:97–107CrossRefPubMedGoogle Scholar
  54. 54.
    Alanen V, Taimela S, Kinnunen J et al (1998) Incidence and clinical significance of bone bruises after supination injury of the ankle. A double-blind prospective study. J Bone Joint Surg Br 80:513–515CrossRefPubMedGoogle Scholar
  55. 55.
    Vellet AD, Marks PH, Fowler PJ et al (1991) Occult posttraumatic osteochondral lesions of the knee: prevalence, classification and short-term sequelae evaluated with MR Imaging. Radiology 178:271–276CrossRefPubMedGoogle Scholar
  56. 56.
    Costa-Paz M, Musculo DL, Ayerza M et al (2001) Magnetic resonance imaging follow-up study of bone bruises associated with anterior cruciate ligament ruptures. Arthroscopy 17:445–449CrossRefPubMedGoogle Scholar
  57. 57.
    Davies NH, Niall D, King LJ et al (2004) Magnetic resonance of bone bruising in the acutely injured knee-short-term outcome. Clin Radiol 59:439–445CrossRefPubMedGoogle Scholar
  58. 58.
    Major NM, Helms CA (2002) MR imaging of the knee: findings in asymptomatic collegiate basketball players. Am J Roentgenol 179:641–644CrossRefGoogle Scholar
  59. 59.
    Schueller-Weidekamm C, Schueller G, Uffmann M et al (2006) Does marathon running cause acute lesions of the knee? Evaluation with magnetic resonance imaging. Eur Radiol 16:2179–2185CrossRefPubMedGoogle Scholar
  60. 60.
    Lovell G, Galloway H, Hopkins W et al (2006) Osteitis pubis and assessment of bone marrow edema at the pubic symphysis with MRI in an elite junior male soccer squad. Clin J Sport Med 16:117–122CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  1. 1.1st Department of RadiologyUniversity of Athens School of MedicineAthensGreece

Personalised recommendations