The term “bone marrow edema” is often found in hospital tests or diagnostic results. What does it mean when bone marrow edema is found? What kinds of diseases are seen? Does it mean that the disease is serious? Can it disappear after treatment? Similar questions are frequently asked, especially on the Internet. Most of the articles or answers are based on a single aspect or description, such as traumatic, ischemic, etc., without answering more aspects.
The term “bone marrow edema” emerged with the application of magnetic resonance imaging (MRI), which means that only MRI examinations can detect the presence of bone marrow edema at an early stage, because MRI examinations are very sensitive to water and the bone marrow edema shown is more characteristic, so the diagnosis can be made directly. That is, the bone marrow edema area is white on the T2WI compression lipid image of MRI and black on T1WI. Other imaging tests are not able to detect or diagnose bone marrow edema (including X-rays, CT, PET-CT, ultrasound, etc.).
”Bone marrow edema” it is only one of the manifestations, or a certain stage, of certain diseases and is not a separate disease.
Its appearance can be seen in.
1. Infectious diseases of bone.
Bacterial infections, such as tuberculosis of the bone and joint, septic infections, or other types of bacterial or pathogenic infections, which are caused by an increase in the water component of the bone tissue due to the infiltration of inflammatory cells, i.e., bone marrow edema.
2. Bone and joint trauma.
Due to fracture, bone injury (although there is no fracture of the backbone, but there is a fracture of the bone trabeculae), fatigue fracture, etc. and make the water component in the diseased bone increase.
3, tumor.
In some bone tumors, especially malignant bone tumors, the water component in the lesion area or adjacent bone tissue increases due to the infiltration of tumor cells or or other accompanying pathological factors.
4. Ischemic diseases of bone.
Necrosis of bone tissue due to ischemia, in the progressive stage: interruption and fragmentation of bone trabeculae in the lesion area, which makes the water component of the necrotic area or adjacent bone tissue increase.
5. Immune diseases of bone and joint.
The most common is rheumatoid arthritis, ankylosing spondylitis, etc., due to synovial or tendon ligament and other soft tissue proliferative lesions caused by bone lesions, the lesion area of bone appears monocytes, lymphocytes and other inflammatory cell infiltration with increased water components.
6, degenerative osteoarthropathy.
Due to degeneration of the intervertebral disc or degeneration and destruction of articular cartilage, the formation of vertebral endplate inflammation or subchondral cystic changes or edema.
7, diseases of the blood system.
For example, leukemia, which is accompanied by bone marrow edema due to bone marrow infiltration of leukemia cells.
8, Other.
Such as transient bone marrow edema of unknown cause (for example, common femoral head and neck, which are self-limiting diseases with unknown cause); toxic bone diseases, such as cadmium poisoning, which causes bone dissolution with bone marrow edema; gouty arthropathy (abnormal purine metabolism), etc.
From the above, “bone marrow edema” can be seen in many kinds of diseases, and it can be seen in the following cases: 1.
1, the lesion belongs to the early stage, such as rheumatoid arthritis, ankylosing spondylitis, or the progressive stage of the disease, active stage; or other infectious bone disease in the progressive stage; fresh or progressive bone ischemic necrosis, etc.
2, fresh fracture or injury, such as fresh bone injury caused by trauma, fresh vertebral fracture, etc.
3. Tumors of bone are mostly malignant, such as osteosarcoma, lymphoma, metastasis, myeloma, etc.
Some “bone marrow edema” disappears with treatment or disease regression, suggesting disease improvement; some “bone marrow edema” will worsen with the progress of the disease, such as serious infection, malignant tumor, etc.