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Foot and Ankle Bone Marrow Edema Assessment in Long Distance Runners
Ryan Hatch1, Paul Devito2, Megan Reams2
1Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.
Background:
The clinical significance of foot and ankle bone marrow edema (BME) is poorly understood.
Methods:
Magnetic resonance imaging (MRI) and the visual analog scale (VAS) pain scores were collected for 17 runners who participated in the Twin Cities Marathon, immediately postmarathon and at a 6-week follow-up. Bone marrow edema lesions were classified using lesion frequency, anatomical location, and grading scale change to calculate a BME score for each affected bone. Spearman rank correlation coefficient test was used to identify a possible correlation between VAS and postmarathon BME. A paired Student t test was used to detect differences between total mileage ran 6 weeks postmarathon in participants with or without BME.
Results:
After completing the marathon, 8 BME lesions were identified in 5 participants (29.4%; 5/17), 3 were men, and 2 were women, with a mean age of 33.8 years (range: 24-52), and BMI of 22.9 ± 4. All lesions were resolved on 6-week follow-up imaging. VAS pain scores did not correlate with postmarathon BME. A significant difference in total miles logged over 6 weeks postmarathon could not be found among participants with and without BME.
Conclusion:
Foot and ankle BME changes identified by MRI were not correlated to clinical symptoms and may resolve with self-directed activity in less time than other areas of the lower extremity.
Level Of Evidence:
Level II, Prospective Cohort Study.
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