Bone Marrow Edema: pathogenetic features (Narrative review)
V. 173 N. 5 (2022), Review
V. 173 N. 5 (2022)

Bone Marrow Edema: pathogenetic features (Narrative review): doi: 10.7417/CT.2022.2459

Review
Pubblicato 2022-09-28
L. Molfetta
University of Genoa, School of Medical and Pharmacological Sciences, DISC Department, Research Center of Osteoporosis and Osteoarticular Pathologies, Genoa, Italy
A. Florian
University of Genoa - School of Medical and Pharmacological Sciences - DISC Department - Genoa (Italy) Research Center of Osteoporosis and Osteoarticular Pathologies (Italy)
G. Saviola
Istituti Clinici Scientifici Maugeri, IRCCS Castel Goffredo, Mantua, Italy
B. Frediani
University of Siena, Rheumatological Unit, Siena, Italy
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Parole chiave

bone marrow edema
nflammation
bisphosphonates
imaging

Abstract

The term “bone marrow edema” was used for the first time in 1988 by Wilson. He noticed a high signal on fluid-sensitive sequences at MRI located in the subchondral bone. We can find bone marrow edema in many musculoskeletal diseases such as Inflammatory and Rheumatic diseases (Rheumatoid Arthritis, Spondylarthritis, etc.), Osteoarthritis (BMLs) and Bone Marrow Edema Syndromes (BMES).

This classification is based on pathophysiological, histological and clinical differences despite the same imaging evidence. The distinction is useful also in terms of treatment. Bisphosphonates in association with NSAIDs or corticosteroids are the main therapy while TNF-a Inhibitors are used for the specific inflammatory origin.

Bone marrow edema has become an important aspect to consider in the diagnostic path of the main musculoskeletal diseases.  This paper starts from a systematic review of literature. We chose the most decisive contributions in order to develop a better description of the pathogenetic features about this “new” evidence.

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