Bone marrow edema in osteoarthritis and bone trauma. Diagnose and treatment.

Background: Bone marrow edema (BME) is a nonspecific response of bone to several different diseases with various pathogenesis or to traumatic events. At the moment BME can clearly be evidenced with RMI only, overall with T2 and STIR sequences, or with dual-energy CT scan. Osteoarthritis (OA) is the most frequent and disabling rheumatological disease affecting millions patients all over the world. Nevertheless traumatic events (TE) are also very common. Both conditions are able to induce BME, but in case of TE diagnosis can be often easy and immediate. Contrary, in OA, BME is not always present, depending on the subtype of the disease. Moreover a correct and meticulous anamnesis and a differential diagnosis with other rheumatological diseases should be performed to avoid false roads.

Conclusions: Bisphosphonates (BPs), in particular Neridronate (NER) and Clodronate (CLO) are, at the moment, the most studied treatments for BME. However other cares with hyperbaric oxygen treatment or pulse electromagnetic fields can be also used in TE. In this review GEODEIT (Gruppo Edema Osseo, Diagnosi e Interventi Terapeutici), an italian scientific society discusses about diagnose and treatment of both, OA and TE conditions.