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Bone Marrow Edema Syndrome as an Emerging Clinical Condition: Investigating the Link with Bone Status-A Single-Center
Carla Caffarelli1, Antonella Al Refaie1,2, Guido Cavati1
1Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy.
Journal of Clinical Medicine
|August 13, 2026
Summary
Bone Marrow Edema Syndrome (BMEs) and Complex Regional Pain Syndrome type 1 (CRPS-1) are linked to lower bone mineral density (BMD) and poorer bone microarchitecture. Osteoporosis is more common in these patients, suggesting shared pathways.
Area of Science:
- Orthopedics
- Radiology
- Endocrinology
Background:
- Bone Marrow Edema Syndrome (BMEs) presents with pain and subchondral bone MRI signals.
- This study investigates bone health in BMEs patients, including Complex Regional Pain Syndrome type 1 (CRPS-1).
Purpose of the Study:
- To compare bone mineral density (BMD) and bone turnover markers in BMEs patients versus healthy controls.
- To assess bone microarchitecture using Trabecular Bone Score (TBS) in BMEs patients.
Main Methods:
- Retrospective analysis of 165 BMEs patients (CRPS-1, hip BMEs, knee BMEs) and 150 healthy controls.
- Dual-Energy X-ray Absorptiometry (DXA) for BMD, TBS calculation for bone microarchitecture.
- Assessment of vitamin D levels and bone turnover markers.
Main Results:
- BMEs patients showed significantly lower BMD and TBS values compared to controls.
- Osteoporosis prevalence was higher in all BMEs subgroups, notably in CRPS-1 and hip BMEs.
- No significant differences in vitamin D or bone turnover markers were found between groups.
Conclusions:
- CRPS-1 and hip/knee BMEs patients have increased osteoporosis prevalence and compromised bone microarchitecture.
- Altered BMD and TBS parameters are significantly associated with BME-related conditions.
- Findings suggest a potential shared pathophysiological link in these bone conditions.
