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However, despite the growing interest on BMLs in multiple pathological conditions, they remain controversial not only for the still unknown role in the etiopathological processes, but also in terms of clinical impact and treatment. The differential diagnosis includes a wide range of conditions: traumatic contusion and fractures, cyst formation and erosions, hematopoietic and infiltrated marrow, developmental chondroses, disuse and overuse, transient bone marrow oedema syndrome and, lastly, subchondral insufficiency fractures and true osteonecrosis. Regardless the heterogeneous spectrum of these pathologies, a key factor for patient management is the distinction between reversible and irreversible conditions. To this regard, MRI plays a major role, leading to the correct diagnosis based on recognizable typical patterns that have to be considered together with coexistent abnormalities, age, and clinical history. Several treatment options have been proposed, from conservative to surgical approaches. In this manuscript the main lesion patterns and their management have been analysed to provide the most updated evidence for the differential diagnosis and the most effective treatment.<\/jats:p><jats:p><jats:italic>Level of evidence<\/jats:italic> IV.<\/jats:p>","DOI":"10.1007\/s00167-016-4113-2","type":"journal-article","created":{"date-parts":[[2016,4,14]],"date-time":"2016-04-14T04:24:58Z","timestamp":1460607898000},"page":"1797-1814","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":117,"title":["Bone marrow lesions and subchondral bone pathology of the knee"],"prefix":"10.1002","volume":"24","author":[{"given":"Elizaveta","family":"Kon","sequence":"first","affiliation":[{"name":"Biomechanics and Technology Innovation Laboratory II Orthopaedic and Traumatologic Clinic Rizzoli Orthopaedic Institute Bologna Italy"},{"name":"Nano\u2010Biotechnology Laboratory Rizzoli Orthopaedic Institute Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Ronga","sequence":"additional","affiliation":[{"name":"Orthopaedics and Traumatology \u2010 Department of Biotechnology and Life Sciences (DBSV) University of Insubria Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Filardo","sequence":"additional","affiliation":[{"name":"Biomechanics and Technology Innovation Laboratory II Orthopaedic and Traumatologic Clinic Rizzoli Orthopaedic Institute Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Farr","sequence":"additional","affiliation":[{"name":"OrthoIndy Cartilage Restoration Center Indiana University School of Medicine Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henning","family":"Madry","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Center of Experimental Orthopaedics Saarland University Medical Center Homburg\/Saar Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Milano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Catholic University A. 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