Histopathological perspective on bone marrow oedema, reactive bone change and haemorrhage

Thiryayi, W.A.; Thiryayi, S. A.; Freemont, Anthony J.

doi:10.1016/j.ejrad.2008.01.056

Cited by 107 publications

(74 citation statements)

References 58 publications

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“…The lesion is not a typical edema by histologic criteria. 1 Rather, it is characterised by fibrosis, lymphocytic infiltrates and increased vascularisation. It is probably the latter that is responsible for the water signal seen on MR.…”

Section: Imagingmentioning

confidence: 99%

“…1 Bone bruises occur most often in the knee but also constitute important differentials in the hip, calcaneus and scaphoid.…”

Section: Clinical Features Of Bml Syndromesmentioning

confidence: 99%

“…5 BMLs give rise to a water signal on MRI, and it has been suggested that this water signal may be due to either capillary leakage caused by local change in the capillary wall (due to, for example, trauma, tumour) or by increased intravascular pressure either due to increased blood flow to the marrow or decreased venous clearance of the marrow space. 1 The MRI characteristics of BML include hypodense lesions on T1-weighted sequences and hyperdense lesions on T2-weighted sequences ( Figure 1). Moreover, the lesions are characterised by homogeneity and the absence of sharp margins, and they cross anatomical boundaries.…”

Section: Imagingmentioning

confidence: 99%

“…As later histological analyses of such lesions were unable to demonstrate oedematous changes at the tissue level in the vast majority of cases, the alternative term 'bone marrow lesion' was introduced. 1 Since then a wealth of publications have detailed the presence of BML in a wide variety of conditions ( Table 1). The presence of BML has been shown to be associated with pain and progression of disease in numerous studies, 2 and therefore various modalities have been tested as treatment options in the hope that they might reduce pain and progressions of disease.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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Bone marrow lesions (BMLs) or using older terminology 'Bone marrow edema' is characterised by excessive water signals in the marrow space on magnetic resonance imaging or ultrasound; BMLs constitute a central component of a wide variety of inflammatory and non-inflammatory rheumatologic conditions affecting the musculoskeletal system: BMLs are not only considered significant sources of pain but also linked to increased disease activity in many musculoskeletal conditions (for example, osteoarthritis, rheumatoid arthritis). The purpose of this review is to summarise current knowledge about the treatment of BMLs, with an emphasis on the clinical and histological features of this entity in inflammatory and non-inflammatory disease. We also try to pair this hypothesis with the apparent beneficial effects of various treatment regimens, mainly within the group of bone antiresorptive drugs (calcitonin, bisphosphonates) on symptoms associated with BMLs.

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Section: Imagingmentioning

confidence: 99%

“…1 Bone bruises occur most often in the knee but also constitute important differentials in the hip, calcaneus and scaphoid.…”

Section: Clinical Features Of Bml Syndromesmentioning

confidence: 99%

Section: Imagingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of bone marrow lesions (bone marrow edema)

Eriksen

2015

BoneKEy Reports

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“…Trabecular microfractures, edema, and hemorrhage following trauma show increased amounts of interstitial fluid and blood that cause an increase in the CT numbers (20,21). Compared with peripheral fractures, vertebral compression fractures have different features of more often subtle initiating trauma and lesser symptoms (22).…”

Section: Image Analysismentioning

confidence: 99%

Bone Marrow Edema in Vertebral Compression Fractures: Detection with Dual-Energy CT

Wang

Tsai

Chuang³

et al. 2013

Radiology

150

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Purpose:To assess the use of the dual-energy computed tomographic (CT) virtual noncalcium technique in the evaluation of bone marrow edema in vertebral compression fractures. Materials and Methods:This prospective study was approved by the institutional review board; informed consent was obtained from all patients. Sixty-three consecutive patients with 112 thoracic and/or lumbar vertebral compression fractures were studied between January 2011 and April 2012. All patients underwent both dual-energy CT (100 kV and Sn140 kV, where Sn indicates the use of a 0.4-mm tin filter) and magnetic resonance (MR) imaging. Dual-energy CT data were postprocessed by using a three-material decomposition algorithm for generating noncalcium images of the collapsed bodies. Two radiologists evaluated for the presence of abnormal attenuation alterations in the bone marrow by using color-coded maps and measured CT numbers on noncalcium grayscale images. Bone sclerosis and intravertebral air were evaluated with CT scans. MR images served as the reference standard. CT numbers were subjected to receiver operating characteristic curve analysis. Results:MR imaging depicted 46 edematous and 66 nonedematous vertebral compression fractures. Eighty-two bodies were classified as having less than 50% sclerosis and/or air. Significant differences in noncalcium CT numbers between edematous and nonedematous vertebral compression fractures were found for both readers (P , .0001).CT numbers for the diagnosis of bone marrow edema on the basis of MR imaging revealed areas under the receiver operating characteristic curve of 0.799 and 0.841 for readers 1 and 2, respectively (P = .56). Use of a cutoff value of 280 to differentiate edematous vertebral bodies resulted in a sensitivity of 96.3%, specificity of 98.2%, and accuracy of 97.6% in the group of vertebral bodies with less than 50% sclerosis and/or air. Conclusion:Dual-energy CT virtual noncalcium images were able to depict bone marrow in the collapsed vertebral bodies, especially in those with less than 50% sclerosis and/or air.q RSNA, 2013

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Quantification of spinal bone marrow fat fraction using three‐material decomposition technique on dual‐energy CT: A phantom study

Hua

et al. 2023

Medical Physics

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Background Two‐material decomposition is insufficient to quantify the fat fraction of spinal bone marrow, which is comprised of a mixture of bone minerals, water, and yellow marrow (fat). Purpose To develop an accurate three‐material decomposition‐based bone marrow fat fraction (FF3MD$F{F_{3MD}}$) quantification technique for dual‐energy CT. Methods Bone marrow edema phantoms containing trabecular bone minerals, water, and fat were constructed using fat fractions and bone mineral density values matching those expected in healthy and edematous bone, and scanned on a commercial dual‐energy CT. Fat quantified by FF3MD$F{F_{3MD}}$ were compared to MRI‐based fat fraction (FFMRI$F{F_{MRI}}$) and conventional two‐material‐decomposition‐based fat fraction (FF2MD$F{F_{2MD}}$) to evaluate its accuracy and dependency on various bone mineral densities. Results FF3MD$F{F_{3MD}}$ demonstrated an excellent correlation with FFMRI0.28em$F{F_{MRI}}\;$(r = 0.97, R2 = 0.96) in the phantom, significantly more accurate than FF2MD when confounding bone minerals are present (50 mg/cm3: r = 1.02, R2 = 0.95 vs. r = 0.65, R2 = 0.79 (p < 0.01); 100 mg/cm3: r = 0.81, R2 = 0.47 vs. r = 0.21, R2 = 0.21 (p < 0.05)). Conclusions FF3MD$F{F_{3MD}}$ accurately quantified bone marrow fat fraction, when compared with FFMRI$F{F_{MRI}}$, in the specially constructed bone marrow phantom.

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Histopathological perspective on bone marrow oedema, reactive bone change and haemorrhage

Cited by 107 publications

References 58 publications

Treatment of bone marrow lesions (bone marrow edema)

Treatment of bone marrow lesions (bone marrow edema)

Bone Marrow Edema in Vertebral Compression Fractures: Detection with Dual-Energy CT

Quantification of spinal bone marrow fat fraction using three‐material decomposition technique on dual‐energy CT: A phantom study

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