Journal of Clinical Medicine (Feb 2020)

How We Manage Bone Marrow Edema—An Interdisciplinary Approach

  • Sebastian F. Baumbach,
  • Vanessa Pfahler,
  • Susanne Bechtold-Dalla Pozza,
  • Isa Feist-Pagenstert,
  • Julian Fürmetz,
  • Andrea Baur-Melnyk,
  • Ulla C. Stumpf,
  • Maximilian M. Saller,
  • Andreas Straube,
  • Ralf Schmidmaier,
  • Jan Leipe

DOI
https://doi.org/10.3390/jcm9020551
Journal volume & issue
Vol. 9, no. 2
p. 551

Abstract

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Bone marrow edema (BME) is a descriptive term for a common finding in magnetic resonance imaging (MRI). Although pain is the major symptom, BME differs in terms of its causal mechanisms, underlying disease, as well as treatment and prognosis. This complexity together with the lack of evidence-based guidelines, frequently makes the identification of underlying conditions and its management a major challenge. Unnecessary multiple consultations and delays in diagnosis as well as therapy indicate a need for interdisciplinary clinical recommendations. Therefore, an interdisciplinary task force was set up within our large osteology center consisting of specialists from internal medicine, endocrinology/diabetology, hematology/oncology, orthopedics, pediatrics, physical medicine, radiology, rheumatology, and trauma surgery to develop a consenus paper. After review of literature, review of practical experiences (expert opinion), and determination of consensus findings, an overview and an algorithm were developed with concise summaries of relevant aspects of the respective underlying disease including diagnostic measures, clinical features, differential diagnosis and treatment of BME. Together, our single-center consensus review on the management of BME may help improve the quality of care for these patients.

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