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The two main features of a long bone are the diaphysis and the epiphysis.
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Atraumatic Bone Marrow Edema Involving the Epiphyses.

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Bone marrow edema (BME)-like signals in bone epiphyses are common MRI findings. Differentiating BME from other bone marrow conditions is crucial for accurate diagnosis and treatment of various musculoskeletal disorders.

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Area of Science:

  • Musculoskeletal Radiology
  • Bone Pathology
  • Medical Imaging

Background:

  • Bone marrow edema (BME)-like signal intensity in tubular bone epiphyses is a common finding on magnetic resonance imaging (MRI).
  • This finding is associated with numerous bone and joint disorders, necessitating differentiation from cellular infiltration.
  • Understanding the differential diagnosis is critical for appropriate patient management.

Approach:

  • This review focuses on nontraumatic conditions causing epiphyseal BME-like signals in adults.
  • It examines pathophysiology, clinical presentation, histopathology, and imaging characteristics.
  • The review covers transient bone marrow edema syndrome, subchondral insufficiency fracture, avascular necrosis, osteoarthritis, arthritis, and bone neoplasms.

Key Points:

  • Epiphyseal BME-like signals on MRI can indicate various conditions, including transient bone marrow edema syndrome, insufficiency fractures, avascular necrosis, osteoarthritis, arthritis, and neoplasms.
  • Accurate interpretation of MRI findings is essential to distinguish BME from bone marrow infiltration.
  • A comprehensive understanding of these entities aids in diagnosing and managing adult musculoskeletal disorders.

Conclusions:

  • Epiphyseal BME-like signals on MRI represent a diverse group of nontraumatic conditions.
  • Distinguishing BME from other marrow pathologies is key for effective diagnosis.
  • This review provides a framework for evaluating these common MRI findings in the adult musculoskeletal system.