Bone Marrow Edema and Joint Overuse in Athletes: a Mini-Review Volume 4 - Issue 2

Tarantino U^1,2, Primavera M^1,2, Greggi C^2,3,4, Iundusi R^1,2, Gasbarra E^1,2 and Gatti A^1,2

• ¹Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Italy
• ²Department of Orthopedics and Traumatology, Italy
• ³Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
• ⁴Medical Biotechnologies and Translational Medicine, University of Rome Tor Vergata, Italy

Received: May 17, 2020;   Published: June 15, 2020

Corresponding author: Gatti A, Department of Clinical Science and Translational Medicine, University of Rome, Italy Department of Orthopedics and Traumatology, Italy

DOI: 10.32474/OSMOAJ.2020.04.000183

 

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Abstract

Bone marrow edema (BME) is defined as an area of low signal intensity on Tl-weighted MR images and associated with intermediate or high signal intensity findings on T2-weighted MR images. Although BME is clearly present at MRI in subjects who already experience joint pain, what makes it difficult to trace the origin of this clinical picture, and thus to establish the correct treatment, is the fact that BME is also found in asymptomatic patients. In fact, BME represents a typical imaging finding that characterizes stress-related bone injury, a common feature of athletes and military recruits, but also amateur athletes. There are several factors that contribute to the etiology of stress injuries, such as changes in an existing training regimen or, as is often seen in non-professional athletes, the undertaking of a new sport or activity. MRI plays a key role in the detection of bone abnormalities since this imaging technique allows detailed evaluation of BME as a consequence of physical performance. These bone changes detected at MRI can help in identifying the stress injuries at an early stage, and this is essential to avoid serious physical, professional, and financial consequences for professional athletes. The clinical significance of BME is still unclear, but it is important to correlate BME imaging findings with the clinical history of the patient and the specific sport performed; it is also crucial to clarify whether there is a specific threshold, during exercise-triggered bone remodeling, beyond which this condition degenerates into the clinical picture characterized by BME, pain and, in more severe cases, a stress fracture. This is necessary to help clinicians and trainees to ensure an accurate diagnosis and therapeutic treatment, and the proper workout adjustment respectively.

Keywords: Bone Marrow Edema; Magnetic Resonance Imaging; Athletes, Sport; Joint Overuse; Pain; Bisphosphonate

Abbreviations: BME: Bone Marrow Edema; BML: Bone Marrow Lesions; MRI: Magnetic Resonance Imaging; Pemfs: Pulsed Electromagnetic Fields; CPRS: Complex Pain Regional Syndrome.

Abstract| Bone Marrow Edema (BME): on overview| Non-Traumatic BME Onset| Etiopathogenesis of BME| BME and Pain| How Training Influence BME Size| Update On BME Therapeutic Management| Discussion: What Is New For The Clinician| Conclusions| Conflict of Interest| References|