Abstract
Introduction: Intra-articular migration of bone marrow edema syndrome (BMES) is a very unusual pattern of disease which has been previously described in only a few cases and may raise the suspicion of an aggressive disease.
Materials and Methods: We reviewed 8 patients (4 women, 4 men) with unilateral BMES located in the knee. The patients were aged 39 to 56 years (mean 50.2). In all the patients, bone marrow edema found in the primary magnetic resonance imaging (MRI) migrated within the same joint, i.e. from the medial to the lateral femoral condyle or to the neighboring bone. Conservative therapy including limited weight-bearing for a period of three weeks was provided for seven patients after initial detection of BMES and one patient underwent surgical core decompression twice.
Results: MRI showed complete restitution in 6 cases and small residual edema in one case. A final MRI control was not obtained in one painless patient. In one patient, avascular necrosis of the contralateral hip was evident after 16 months. Improvement of the MRI pattern was correlated with the clinical outcome in all patients. All patients became asymptomatic after a mean of 9 months (range, 6–11).
Conclusion: Intra-articular migrating BMES is a condition seen very rarely. The disease is self-limited so that conservative therapy can be recommended.
The abstracts were prepared by Lynne C. Jones, PhD. and Michael A. Mont, MD. Correspondence should be addressed to Lynne C. Jones, PhD., at Suite 201 Good Samaritan Hospital POB, Loch Raven Blvd., Baltimore, MD 21239 USA. Email: ljones3@jhmi.edu
