Bone Marrow Edema

Bone marrow edema is when fluid builds up in your bone marrow. Your doctor may call it bone marrow lesions. The most common locations for it are your:

Bone marrow is soft, spongy tissue that's in the middle of most of your bones. It contains blood stem cells. Those are special cells that can eventually become red blood cells, white blood cells, or platelets.

Edema is swelling that happens when fluid builds up in your body.

Bone marrow edema can be painful, but there are treatments for it. In some cases, it goes away on its own.

Causes

Bone marrow edema can happen for many reasons, including:

Injury. A few different ones can lead to bone marrow edema. They include:

Arthritis. Many types, including osteoarthritis and rheumatoid arthritis, cause bone marrow edema. In the case of osteoarthritis, the edema usually appears -- along with loss of cartilage -- as the disease gets worse.

Osteoporosis. As bones become weak and start to break easily, bone marrow edema is more likely. It’s particularly common when osteoporosis affects the knee and hip.

Bone tumors. Some cancers can cause extra fluid to show up in bones. This can trigger edema in the marrow. Radiation treatment for cancer can also make bone marrow edema more likely.

Bone infections. When your body fights a bone infection (your doctor may call it osteomyelitis), your tissues tend to swell. That can bring extra fluid in your bones.

Symptoms

If you have bone marrow edema, you may or may not have symptoms.

Pain is usually the main sign that something is wrong. You might also notice swollen joints. Your doctor might call this joint effusion. It's common when you have edema around your knees.

Your knees also might be swollen, warm, and painful.

Diagnosis

If your doctor thinks you may have bone marrow edema, you’ll get a physical and they'll ask you questions about your medical history. Also, you’ll probably have blood tests to look for heavy inflammation in your body.

Bone marrow edema doesn’t show up on an X-ray or CT scan. So if needed, your doctor will use an MRI or ultrasound to see if you have it.

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Treatments

In many cases, bone marrow edema will go away with rest, therapy, and pain meds like nonsteroidal anti-inflammatory drugs (NSAIDs). You may have to rest for several months to feel better.

In more serious cases, your doctor may suggest other medicines and surgery. One procedure, core depression surgery, involves drilling tiny holes in the affected area to release pressure and ease pain. Your surgeon may then fill the holes with stem cells or bone graft material to help healthy bone marrow grow.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on June 25, 2020

Sources

SOURCES:

Bonekey Reports: “Treatment of bone marrow lesions (bone marrow edema)."

Orthopedic Clinics of North America: “Technologies in the Treatment of Bone Marrow Edema Syndrome.”

National Cancer Institute: “Bone Marrow.”

Mayo Clinic: “Edema,” "Plantar fasciitis," “Stress Fractures.”

Journal de Radiologie: “Bone marrow edema: definition, diagnostic value and prognostic value.”

Magnetic Resonance Insights: “Bone Marrow Lesion: Image, Clinical Presentation, and Treatment.”

Journal of Clinical Medicine: “How We Manage Bone Marrow Edema—An Interdisciplinary Approach.”

American Family Physician: “Acute Knee Effusions: A Systematic Approach to Diagnosis.”

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