Core decompression shortens the duration of pain in bone marrow oedema syndrome

We studied nine patients with 12 painful hips without apparent cause but with alteration of signal intensity on magnetic resonance imaging (MRI) consistent with bone-marrow oedema. The patients were randomly assigned to receive conservative or surgical treatment with core decompression. The duration of pain was significantly less in those treated surgically. Histological evaluation of the material obtained from 4 decompressions confirmed bone-marrow oedema without osteoporosis. Bone mineral density studies in 5 patients were normal. Although bone-marrow oedema of the femoral head is usually a self-limiting condition, we suggest that core decompression should be considered, as the symptoms may be prolonged and incapacitating.