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What are the Causes of Bone Marrow Edema?

By Erin J. Hill
Updated Mar 03, 2024
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The most common causes of bone marrow edema are injury to the bone itself or to the surrounding connective tissue. It may also be caused by osteoarthritis and other joint disorders. Occasionally, it may be the result of bone cancer, inflammation of the synovial membrane, and bruising.

In simple terms, bone marrow edema is a collection fluid in the bone marrow. Bone marrow is the spongy substance inside many of the bones of most animals and humans. It contains a variety of important biological materials and is responsible for the manufacturing of white and red blood cells.

Most causes of edema in bone marrow are related to an injury to the bone or the surrounding area. This can include fractures, bruises, and torn tissue. Those who play high impact sports are at a higher risk for developing the condition, because sports-related injuries are common. These injuries generally heal with proper treatment, and fluid buildup typically decreases gradually as the bone heals.

Certain autoimmune disorders, such as osteoporosis and osteoarthritis, can also cause edema. They typically cause swelling at the joints, which can in turn lead to damage and injury over time. This often leads to fluid buildup and can cause severe pain and swelling. Medications may help to alleviate symptoms, although there is no cure for either of these conditions.

Rarely, cancer of the bones or a tumor will be the cause of bone marrow edema. These can include cancers that impact the marrow directly, such as leukemia. Cancer may be treated with surgery to remove tumors, chemotherapy, radiation, and a bone marrow transplant. Sometimes, a tumor found in the bone marrow is noncancerous and is removed if it causes pain or swelling, but these benign tumors are generally not life threatening.

Bone marrow edema can cause severe and chronic pain for sufferers. Treatments generally include anti-inflammatory medications, pain relievers, and additional medications targeted at the underlying cause of edema. On rare occasions, surgery may be performed to relieve the condition. The most common procedure is called core decompression, and it requires a hole to be drilled into the area to allow increased blood flow.

Patients may not realize they have bone marrow edema based on the symptoms alone, which can include stiffness, pain, and swelling in the joints and bones. Diagnosis is usually made based on the results of various clinical tests, including magnetic resonance imaging (MRI). Once it is determined that there is fluid in the marrow, additional tests may be done to find the underlying cause.

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Discussion Comments
By anon939597 — On Mar 14, 2014

I have the same problem as you anon 257837. I was diagnosed in February after an MRI. Luckily I live in Sweden and get that MRI paid by our taxes.

By anon314230 — On Jan 16, 2013

I just found out tonight my 10 year old has this though an MRI because all the X-ray showed was an extra bone, but the MRI showed bruising and cracking like an egg on the bones in her feet. I will be researching this as much as possible.

By anon257837 — On Mar 29, 2012

I have been suffering with this pain for over two weeks and can barely lift my leg. It is very difficult to walk. The doctor says go get an ultrasound. My reply was let's go straight to an MRI. He said that's not the first line choice to see what going on, that if its bursitis or sciatica, the ultrasound will show this. I said in my experience with other issues, the MRI will show what's there where an ultrasound or x ray will not. The doc insisted on an ultrasound. I waited several days for and appointment, took three days off work, it cost me $152 and guess what the ultrasound shows? Nothing wrong!

So I went back to the doctor, who was confused that it showed nothing there and starts guessing. I insisted on an MRI. Another two days off work and cost me $250 guess what? The MRI shows "extensive bone marrow edema superolateral margin femoral head" and subchondral infraction. I went back a third time, which costs me $37 each time. My first comment was "See?" Thank goodness for MRIs. When seeing a doctor, insist on an MRI. Don't waste time. It's your health, your, time and your money.

By anon135166 — On Dec 17, 2010

This is extremely painful and it took nearly two years for me to find a doctor (ortho) that was smart enough to send me for an MRI. Everyone else just asked for an x-ray which obviously revealed nothing broken. Incorrect diagnosis included: osteoarthritis, fibromyalgia, ganglion.

I am now undergoing test to figure out the cause. A little scary considering last year I had a bout with cancer and had three non malignant tumors removed. Looks like round two. If you are going through this, demand a referral to an orthopedic specialist and an MRI, not an x-ray.

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