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Post-traumatic Bone Marrow Edema of the Foot in a Child: A Case Report
Azucena Lirio Armas Alvarez1, Angel Alois Osorio Manyari2
1Urology, Hospital Don Benito-Villanueva de la Serena, Don Benito, ESP.
Abstract:
Bone marrow edema in children is an uncommon condition, most often associated with trauma, and typically presents with persistent pain and difficulty walking. Conservative management, including rest and physical therapy, is commonly used. We report the case of an 11-year-old boy with no significant past medical history who sustained a fall while playing, resulting in right foot pain. One week later, due to persistent pain and difficulty walking, he was evaluated by a traumatologist. Plain radiography showed no abnormalities, and the injury was initially managed as a sprain. As symptoms persisted after two weeks, magnetic resonance imaging (MRI) was performed, revealing bone marrow edema in the right foot. The patient was treated with anti-inflammatory medication, non-weight-bearing, and physical therapy, including magnetotherapy. He used crutches for six months. Follow-up MRI at five months demonstrated resolution of the edema. The patient subsequently resumed swimming and began walking in water, gradually overcoming his fear of weight-bearing. He progressed to ambulation with one crutch and then independently, returning to normal daily activities. A high index of clinical suspicion is important in patients with persistent pain and gait impairment after trauma. MRI is the preferred modality for confirming the diagnosis. This case highlights the potential role of conservative management in pediatric bone marrow edema; however, given the single-case design, the observed recovery may reflect the natural course of the condition.