Learning objectives
Identify typical patterns of bone marrow edema that result from different mechanisms of traumatic knee injury
Explain how each mechanism leads to a specific pattern of bone contusion
Recognize the specific soft-tissue injuries associated with each mechanism
Background
Bone marrow edema (BME) is commonly identified at Magnetic Resonance Imaging (MRI) after knee injury.
These bone abnormalities may result from a direct blow to the bone,
from compressive forces of adjacent bones impacting one another,
or from traction forces that occur during an avulsion injury.
The distribution of bone contusion is a footprint left behind an injury,
providing important clues to the associated soft-tissue injuries.
Imaging findings OR Procedure Details
Bone bruises are focal abnormalities in subchondral bone marrow due to trabecular microfractures as a result from a traumatic force.
[1] They can be due to a direct blow to the bone,
application of compressive forces on contiguous bones with a consequent impact mechanism and the action of torsion force,
or traction forces that occur during an avulsion injury.
[2,3] MRI is better than conventional radiographs,
ultrasound,
computed tomography and also arthroscopy to describe bone bruises and associated soft tissues injuries.
In fact,
MRI has...
Conclusion
Bone marrow contusions are often regarded as benign and self-limiting lesions,
in most cases resolving 4 to 12 months after injury.
However,
when they are associated with subchondral or osteochondral injuries,
they may have deleterious effects producing late degenerative changes.
Therefore it is important to accurately detect underlying soft-tissue injuries which may predict long-term degenerative changes.
MRI is a very sensitive imaging technique to detect bone marrow pathology. It is very common to find signal abnormalities in the subchondral bone marrow of the knee,
involving...
References
Ciuffreda P et al.
Mechanism of traumatic knee injuries and MRI findings.
Musculoskelet Surg (2013) 97:S127–S135
SAHOO K.
at al.
Study of Imaging Pattern in Bone Marrow Oedema in MRI in Recent Knee Injuries and its Correlation with Type of Knee Injury.
Journal of Clinical and Diagnostic Research.
2016 Apr,
Vol-10(4): TC06-TC11
Sanders T.
et al.
Bone Contusion Patterns of the Knee at MR Imaging: Footprint of the Mechanism of Injury.
RadioGraphics 2000; 20:S135–S151
Murphy BJ et al.
Bone signal abnormalities in the posterolateral tibia...
Personal Information
Ana LuĂsa Martins Lourenço
Centro Hospitalar Universitário de Lisboa Central
[email protected]