Asymptomatic bone marrow edema (aBME) is a non-specific radiographic finding
often found in athletes. Although aBME may represent the body's
physiological response to training load, the etiology, MRI characteristics, and
natural history of aBME remain unknown. To better characterize aBME in the lower
extremities of military trainees and athletes. A systematic literature review in
accordance with PRISMA guidelines was performed to identify primary research
articles reporting on aBME in the lower extremities of athletes and military
trainees. We identified 347 unique articles and after applying inclusion and
exclusion criteria, 10 articles were included for qualitative synthesis. There
were a total of 444 patients with an average age of 28.4±9.6 included.
The most commonly used MRI sequences were proton-density with fat-saturation and
T1-weighted imaging. The pattern of BME was inconsistently described, with
various classification schemas used. The changes in aBME during longitudinal
follow-up were dynamic and demonstrated both radiographic progression and
regression. aBME is a highly prevalent and radiographically dynamic entity
observed in high-level athletes and military trainees. Although follow-up was
limited in the included studies, aBME may represent a natural, non-pathologic,
reaction in response to specific biomechanical stressors.