{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T03:21:08Z","timestamp":1764645668780},"reference-count":43,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Musculoskelet Radiol"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Bone marrow edema (BME)-like signal intensity involving the epiphyses of tubular bones represents a frequent magnetic resonance imaging finding associated with a wide spectrum of bone and joint disorders. It is important to distinguish this finding from cellular infiltration of bone marrow and to be aware of the differential diagnosis of underlying causes. With a general focus on the adult musculoskeletal system, this article reviews the pathophysiology, clinical presentation, histopathology, and imaging findings of nontraumatic conditions associated with epiphyseal BME-like signal intensity: transient bone marrow edema syndrome, subchondral insufficiency fracture, avascular necrosis, osteoarthritis, arthritis, and bone neoplasms.<\/jats:p>","DOI":"10.1055\/s-0043-1761498","type":"journal-article","created":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T23:51:39Z","timestamp":1677887499000},"page":"045-053","source":"Crossref","is-referenced-by-count":2,"title":["Atraumatic Bone Marrow Edema Involving the Epiphyses"],"prefix":"10.1055","volume":"27","author":[{"given":"Klaus","family":"Woertler","sequence":"additional","affiliation":[{"name":"Musculoskeletal Radiology Section, TUM, Munich, Germany"},{"name":"Interdisciplinary Musculoskeletal Tumor Center, TUM, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Neumann","sequence":"additional","affiliation":[{"name":"Musculoskeletal Radiology Section, TUM, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,3]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1148\/radiology.167.3.3363136","article-title":"Transient osteoporosis: transient bone marrow edema?","volume":"167","author":"A J Wilson","year":"1988","journal-title":"Radiology"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"963","DOI":"10.2214\/AJR.19.21571","article-title":"Nomenclature of subchondral nonneoplastic bone lesions","volume":"213","author":"T Gorbachova","year":"2019","journal-title":"AJR Am J Roentgenol"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1007\/s002560050434","article-title":"Classification and detection of bone marrow lesions with magnetic resonance imaging","volume":"27","author":"B C Vande Berg","year":"1998","journal-title":"Skeletal Radiol"},{"issue":"03","key":"ref4","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1055\/s-0039-1677872","article-title":"MR imaging of the hip: an update on bone marrow edema","volume":"23","author":"E E Vassalou","year":"2019","journal-title":"Semin Musculoskelet Radiol"},{"issue":"10","key":"ref5","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1016\/j.ejrad.2014.07.017","article-title":"Magnetic resonance perfusion and diffusion imaging characteristics of transient bone marrow edema, avascular necrosis and subchondral insufficiency fractures of the proximal femur","volume":"83","author":"D Mueller","year":"2014","journal-title":"Eur J Radiol"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.ejrad.2008.01.056","article-title":"Histopathological perspective on bone marrow oedema, reactive bone change and haemorrhage","volume":"67","author":"W A Thiryayi","year":"2008","journal-title":"Eur J Radiol"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ejrad.2008.01.052","article-title":"Bone marrow oedema associated with benign and malignant bone tumours","volume":"67","author":"S LJ James","year":"2008","journal-title":"Eur J Radiol"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/S0033-8389(03)00166-0","article-title":"Avascular necrosis and bone marrow edema syndrome","volume":"42","author":"R M Watson","year":"2004","journal-title":"Radiol Clin North Am"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s00256-008-0529-1","article-title":"Bone marrow edema syndrome","volume":"38","author":"A V Korompilias","year":"2009","journal-title":"Skeletal Radiol"},{"key":"ref10","first-page":"57","volume-title":"Hip","author":"M N Pathria","year":"2017"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.ejrad.2014.11.022","article-title":"MR imaging of transient osteoporosis of the hip: an update on 155 hip joints","volume":"84","author":"M E Klontzas","year":"2015","journal-title":"Eur J Radiol"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.ejrad.2004.01.020","article-title":"MR imaging findings in transient osteoporosis of the hip","volume":"50","author":"K N Malizos","year":"2004","journal-title":"Eur J Radiol"},{"issue":"334","key":"ref13","first-page":"73","article-title":"Histomorphology and bone morphometry of the bone marrow edema syndrome of the hip","author":"H Plenk Jr","year":"1997","journal-title":"Clin Orthop Relat Res"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1148\/radiology.212.2.r99au03527","article-title":"Idiopathic bone marrow edema lesions of the femoral head: predictive value of MR imaging findings","volume":"212","author":"B C Vande Berg","year":"1999","journal-title":"Radiology"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"71","DOI":"10.2214\/ajr.170.1.9423603","article-title":"Early irreversible osteonecrosis versus transient lesions of the femoral condyles: prognostic value of subchondral bone and marrow changes on MR imaging","volume":"170","author":"F E Lecouvet","year":"1998","journal-title":"AJR Am J Roentgenol"},{"issue":"01","key":"ref16","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ejrad.2008.01.053","article-title":"Acute non-traumatic marrow edema syndrome in the knee: MRI findings at presentation, correlation with spinal DEXA and outcome","volume":"67","author":"A H Karantanas","year":"2008","journal-title":"Eur J Radiol"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1007\/s00330-015-3967-x","article-title":"Subchondral insufficiency fractures of the femoral head: associated imaging findings and predictors of clinical progression","volume":"26","author":"L A Hackney","year":"2016","journal-title":"Eur Radiol"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s002560100348","article-title":"Subchondral insufficiency fracture of the femoral head: histopathologic correlation with MRI","volume":"30","author":"T Yamamoto","year":"2001","journal-title":"Skeletal Radiol"},{"issue":"11","key":"ref19","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1002\/1529-0131(200011)43:11<2423::AID-ANR8>3.0.CO;2-Z","article-title":"The role of subchondral insufficiency fracture in rapid destruction of the hip joint: a preliminary report","volume":"43","author":"T Yamamoto","year":"2000","journal-title":"Arthritis Rheum"},{"issue":"11","key":"ref20","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1007\/s00256-014-1946-y","article-title":"MRI of subchondral fractures: a review","volume":"43","author":"S L Viana","year":"2014","journal-title":"Skeletal Radiol"},{"issue":"07","key":"ref21","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1007\/s00256-019-3160-4","article-title":"Magnetic resonance imaging of subchondral insufficiency fractures of the lower limb","volume":"48","author":"S Lee","year":"2019","journal-title":"Skeletal Radiol"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s00256-015-2258-6","article-title":"Common site of subchondral insufficiency fractures of the femoral head based on three-dimensional magnetic resonance imaging","volume":"45","author":"K Iwasaki","year":"2016","journal-title":"Skeletal Radiol"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"657","DOI":"10.2214\/ajr.179.3.1790657","article-title":"Rapidly destructive osteoarthritis of the hip: MR imaging findings","volume":"179","author":"N Boutry","year":"2002","journal-title":"AJR Am J Roentgenol"},{"issue":"10","key":"ref24","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00256-004-0777-7","article-title":"MR appearance of SONK-like subchondral abnormalities in the adult knee: SONK redefined","volume":"33","author":"R R Ramnath","year":"2004","journal-title":"Skeletal Radiol"},{"issue":"03","key":"ref25","doi-asserted-by":"crossref","first-page":"570","DOI":"10.2214\/AJR.07.2847","article-title":"MRI of metatarsal head subchondral fractures in patients with forefoot pain","volume":"190","author":"M Torriani","year":"2008","journal-title":"AJR Am J Roentgenol"},{"issue":"07","key":"ref26","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/S0730-725X(01)00424-6","article-title":"Initial changes of non-traumatic osteonecrosis of femoral head in fat suppression images: bone marrow edema was not found before the appearance of band patterns","volume":"19","author":"M Fujioka","year":"2001","journal-title":"Magn Reson Imaging"},{"issue":"09","key":"ref27","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.1007\/s00330-014-3216-8","article-title":"Bone marrow oedema on MR imaging indicates ARCO stage 3 disease in patients with AVN of the femoral head","volume":"24","author":"R Meier","year":"2014","journal-title":"Eur Radiol"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"545","DOI":"10.2214\/ajr.181.2.1810545","article-title":"MR imaging of bone marrow edema and joint effusion in patients with osteonecrosis of the femoral head: relationship to pain","volume":"181","author":"G S Huang","year":"2003","journal-title":"AJR Am J Roentgenol"},{"issue":"06","key":"ref29","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1302\/0301-620X.82B6.0820837","article-title":"The pattern of bone marrow oedema on MRI in osteonecrosis of the femoral head","volume":"82","author":"Y M Kim","year":"2000","journal-title":"J Bone Joint Surg Br"},{"issue":"06","key":"ref30","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.2214\/AJR.05.0086","article-title":"Relationship between bone marrow edema and development of symptoms in patients with osteonecrosis of the femoral head","volume":"186","author":"H Ito","year":"2006","journal-title":"AJR Am J Roentgenol"},{"issue":"03","key":"ref31","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.joca.2020.01.002","article-title":"Osteoarthritis year in review 2019: epidemiology and therapy","volume":"28","author":"M Kloppenburg","year":"2020","journal-title":"Osteoarthritis Cartilage"},{"issue":"S 01","key":"ref32","first-page":"S1","article-title":"The burden of hip osteoarthritis in the United States: epidemiologic and economic considerations","volume":"21","author":"S J Nho","year":"2013","journal-title":"J Am Acad Orthop Surg"},{"issue":"03","key":"ref33","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1148\/radiology.215.3.r00jn05835","article-title":"Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings","volume":"215","author":"M Zanetti","year":"2000","journal-title":"Radiology"},{"issue":"05","key":"ref34","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1007\/s00256-008-0446-3","article-title":"Bone marrow edema pattern in advanced hip osteoarthritis: quantitative assessment with magnetic resonance imaging and correlation with clinical examination, radiographic findings, and histopathology","volume":"37","author":"M S Taljanovic","year":"2008","journal-title":"Skeletal Radiol"},{"issue":"03","key":"ref35","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1055\/s-0031-1278423","article-title":"Bone marrow changes in osteoarthritis","volume":"15","author":"T M Link","year":"2011","journal-title":"Semin Musculoskelet Radiol"},{"issue":"01","key":"ref36","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.mric.2004.01.004","article-title":"MR imaging of septic arthritis and rheumatoid arthritis of the shoulder","volume":"12","author":"D Weishaupt","year":"2004","journal-title":"Magn Reson Imaging Clin N Am"},{"issue":"11","key":"ref37","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1007\/s002560050562","article-title":"The septic versus nonseptic inflamed joint: MRI characteristics","volume":"28","author":"M Graif","year":"1999","journal-title":"Skeletal Radiol"},{"issue":"01","key":"ref38","doi-asserted-by":"crossref","first-page":"119","DOI":"10.2214\/ajr.182.1.1820119","article-title":"MRI findings of septic arthritis and associated osteomyelitis in adults","volume":"182","author":"M Karchevsky","year":"2004","journal-title":"AJR Am J Roentgenol"},{"issue":"05","key":"ref39","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1186\/ar4035","article-title":"Bone marrow edema and osteitis in rheumatoid arthritis: the imaging perspective","volume":"14","author":"F M McQueen","year":"2012","journal-title":"Arthritis Res Ther"},{"issue":"01","key":"ref40","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1148\/rg.301095089","article-title":"MR imaging of early rheumatoid arthritis","volume":"30","author":"J A Narv\u00e1ez","year":"2010","journal-title":"Radiographics"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/BF02412359","article-title":"MR imaging of edema accompanying benign and malignant bone tumors","volume":"23","author":"H M Kroon","year":"1994","journal-title":"Skeletal Radiol"},{"issue":"08","key":"ref42","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1007\/s00330-003-1902-z","article-title":"Benign bone tumors and tumor-like lesions: value of cross-sectional imaging","volume":"13","author":"K Woertler","year":"2003","journal-title":"Eur Radiol"},{"issue":"07","key":"ref43","doi-asserted-by":"crossref","first-page":"4738","DOI":"10.1007\/s00330-022-08586-w","article-title":"Diagnosis of joint invasion in patients with malignant bone tumors: value and reproducibility of direct and indirect signs on MR imaging","volume":"32","author":"J Bodden","year":"2022","journal-title":"Eur Radiol"}],"container-title":["Seminars in Musculoskeletal Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1761498.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,3]],"date-time":"2023-03-03T23:53:07Z","timestamp":1677887587000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1761498"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2]]},"references-count":43,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2023,3,3]]},"published-print":{"date-parts":[[2023,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1761498","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1089-7860","1098-898X"],"issn-type":[{"value":"1089-7860","type":"print"},{"value":"1098-898X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2]]}}}