Bone Marrow Edema in the Knee: Diagnosis and Treatment

Understanding the Clinical Significance

New or increasing bone marrow edema is associated with increased knee pain, particularly in males or patients with a family history of osteoarthritis, as noted by the American College of Radiology 1, 2
Decreasing bone marrow edema correlates with reduced knee pain, according to the American College of Radiology 1, 3
Bone marrow edema can indicate the origin of pain in osteoarthritis patients, as reported by the American College of Radiology 1, 3

Subchondral insufficiency fractures most commonly affect the medial femoral condyle in middle-aged to elderly females and can progress to articular surface fragmentation, subchondral collapse, and may require total knee arthroplasty if untreated, as stated by the American College of Radiology 1, 2, 3
These fractures can progress to articular surface fragmentation, subchondral collapse, and may require total knee arthroplasty if untreated, according to the American College of Radiology 2, 3

New or increasing bone marrow edema correlates with pain and can progress to joint destruction if the underlying cause is not addressed, as noted by the American College of Radiology 1
Rule out subchondral insufficiency fracture early, as MRI identifies these fractures earlier than radiographs, which are often initially normal, according to the American College of Radiology 2, 3
Consider underlying inflammatory arthritis, as bone marrow edema combined with synovitis/effusion may indicate inflammatory disease requiring different management, as reported by the American College of Radiology 1, 3