Definition of Bone Marrow Edema

Fluid buildup is inside a joint can lead to pain and swelling. Fractures or osteoarthritis can give rise to edema, or fluid buildup within the marrow portion of a bone. This temporary condition can appear and disappear on a random basis.

Identification

• In bone marrow edema--or bone marrow edema syndrome (BMES)--the bone marrow becomes inflamed and fills with fluid. BMES is typically a short-term condition that gradually resolves within a three- to four-week time frame. You may have experienced an injury in the affected area or a side effect from osteoarthritis. The cause of the condition will determine the type of treatment you need. BMES can occur in the hips, knees or ankles.

Function

• The fluid buildup of BMES causes pain and pressure to form within the affected bone. This resulting pressure prevents the marrow from producing new blood cells. An inflammatory response from the immune system accompanies the fluid buildup. When BMES results from a fracture, this inflammatory response may protect the area from infection.

Effects

• Because BMES is classified as a "syndrome of symptoms," its appearance on an MRI scan is considered a nonspecific finding that points to a subset of possible causes: rheumatoid arthritis, tendinitis, transient osteoporosis or a fracture.

  If you suffer from osteoarthritis, damaged cartilage structures may give rise to BMES. If you have areas in which developing bone erosions are present, you may have rheumatoid arthritis. Tendon areas that show fluid buildup may indicate a calcification is forming where the tendon enters the bone.

Considerations

• Symptoms associated with bone marrow edema resemble osteonecrosis. Whereas BMES comes and goes, osteonecrosis worsens with time. When the vessels that supply nutrients to the joint are unable to function normally, the actual bone structure of the joint breaks down.

  In osteoarthritis, on the other hand, bone coverings may appear thinned, but the structure remains intact. BMES resulting from bone fractures will still show normal vascular function.

Treatments

• Bone marrow edema treatment centers around relieving pain and conditioning the affected area. Nonsteroidal anti-inflammatory medications can restore normal joint function. If your pain is severe, you may need stronger medications.

  Physical therapy conditioning exercises use weights and are intended to prevent further joint deterioration.

  Medications that promote calcium absorption like calcitonin or parathyroid hormones may strengthen the bone structures within the joint.