How Serious Is Bone Marrow Edema?

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Bone marrow edema is the build-up of fluid in the bone marrow. Bone marrow is the spongy tissue in the center of your bones.

Some healthcare professionals still use the term bone marrow edema. But today, the condition is often called a bone marrow lesion. A lesion is an area of tissue that's not healthy or normal.

This article describes common causes of bone marrow edema. It also explains how the condition is diagnosed and treated.

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Diagnosis

A healthcare professional can identify bone marrow edema with an ultrasound test or magnetic resonance imaging (MRI) scan. The condition is often linked to osteoarthritis, often known as "wear and tear" arthritis, where cartilage breaks down and joints become painful.

The edema can also happen because of a fracture or joint injury. A bone infection (osteomyelitis) sometimes causes the fluid buildup. Bone infections and injuries can often be detected using MRIs as well.

Osteoarthritis

If you have osteoarthritis, bone marrow edema may be a sign that your condition has gotten worse. You may have developed subchondral cysts along with the fluid buildup. They can often be spotted on an MRI.

These cysts occur in places where the cartilage has been damaged. The cartilage hardens and forms fluid-filled sacs (cysts) in the joint. The cysts take up space in the joint, making it narrower. That wears the cartilage away even more. Eventually, bone rubs against bone.

As more and more cartilage is lost, nerves become exposed. You may feel more pain and be less mobile. This is especially true in cases of knee osteoarthritis.

If your knees are not lined up correctly, the condition can get worse. Poor alignment places stress on a joint that's already inflamed.

When compared to people without edema, those with edema are likely to have more severe osteoarthritis symptoms and to get worse more quickly—usually in 15 to 30 months.

Injury

Bone marrow edema can happen with fractures and other serious bone or joint injuries. This is especially true when the injury involves the spine, hip, knees, or ankle.

After an injury, different types of fluid can build up in a bone. It could be blood or fluids released from fibrosis (scarred tissue) or necrosis (tissue death).

Other Causes

Some more causes of bone marrow edema include:

  • Stress fractures of the foot, hip, ankle, or knee from repeated impact and strain on a weight-bearing joint
  • Anterior cruciate ligament (ACL) tears, which involve a key ligament that gives the knee joint stability and can cause bruising and inflammation of connective tissue, called synovitis.
  • Vertebral compression fractures, which are age-related cracks or breaks in the bones of the spine
  • Bone tumors, where fluid weakens the bone and raises the risk of fracture
  • Bone infection (osteomyelitis)
  • Very rarely, dislocation of the hip, which can cut off the blood supply and cause the bone tissue to die (osteonecrosis).

Treatment

Some types of bone marrow edema are harder to treat than others. If the problem is related to a trauma or repetitive motion, it often heals with rest, nonsteroidal pain relievers, and physical therapy. Severe cases may need steroid injections or surgery.

Bone marrow edema affects people in different ways. It tends to resolve in four to 12 months following an injury. But in around 15% of cases, the problem lasts two years or more, even if you're in otherwise perfect health.

Summary

Bone marrow edema is a buildup of fluid inside your bones. It can happen because of an injury such as a fracture. Or it can be related to a health condition like osteoarthritis, an infection, or a tumor.

Your healthcare provider can usually diagnose the problem using ultrasound or an MRI scan. Rest, pain medication, and physical therapy helps many people recover. How long it takes to resolve will have a lot to do with how severe the illness or injury was.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Carol Eustice
Carol Eustice is a writer who covers arthritis and chronic illness. She is the author of "The Everything Health Guide to Arthritis."