Clinical outcome of edema-like bone marrow abnormalities of the foot.

Abstract

PURPOSE:

To evaluate the clinical outcome of edema-like bone marrow abnormalities seen on magnetic resonance (MR) images of the foot when their cause is unknown.

MATERIALS AND METHODS:

The clinical outcome of 31 patients (15 female patients, 16 male patients; mean age, 51; range, 10-79 years) with edema-like bone marrow abnormalities on MR images of the foot was determined. The relevance of three different edema patterns was compared: (a) exclusively ill-defined edema-like zones, (b) edema-like zones plus well-defined necrosis-like zones, and (c) edema-like zones plus linear structures indicating possible fractures. The different edema patterns were compared with persistence of pain.

RESULTS:

Fifty-four percent of all patients had pain persisting after 1 year, as calculated with the Kaplan-Meier method. The duration of pain in the various subgroups varied significantly (P =.049, log-rank test). The subgroup of patients with a well-defined necrosis-like zone had substantially longer-lasting pain than those with edema-like abnormalities only (n = 16) (P =.065). Only one of seven patients with a well-defined necrosis-like zone (n = 7) was pain free after 1 year. Conversely, patients with possible stress fracture (n = 8) had shorter pain compared with those with edema-like abnormalities only (P =.036); six of eight patients were pain free after 1 year.

CONCLUSION:

Edema-like bone marrow abnormalities of the foot predict long-lasting pain. Analysis of the image patterns of such abnormalities allows prediction of the clinical outcome to a certain degree.

• Authors: Marco Zanetti, Christian Luzius Steiner, Burkhardt Seifert, Juerg Hodler
• Journal: Radiology (Radiology) Vol. 222 Issue 1 Pg. 184-8 (Jan 2002) ISSN: 0033-8419 [Print] United States
• PMID: 11756724 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Bone Marrow (pathology)
• Bone Marrow Diseases (complications, diagnosis, pathology)
• Child
• Edema (etiology, pathology)
• Female
• Foot (pathology)
• Fractures, Stress (complications, diagnosis)
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Necrosis
• Pain (etiology)
• Proportional Hazards Models
• Statistics, Nonparametric