HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2221010316v1 222/1/184    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Zanetti, M. Articles by Hodler, J. Search for Related Content PubMed PubMed Citation Articles by Zanetti, M. Articles by Hodler, J.

Clinical Outcome of Edema-like Bone Marrow Abnormalities of the Foot¹

¹ From the Department of Radiology, Orthopedic University Hospital Balgrist, Forchstrasse 340, CH-8008 Zurich, Switzerland (M.Z., C.L.S., J.H.); and the Institute of Biostatistics, University of Zurich, Switzerland (B.S.). From the 2000 RSNA scientific assembly. Received January 15, 2001; revision requested February 18; revision received July 11; accepted July 15. Address correspondence to M.Z. (e-mail: marco.zanetti@balgrist.ch).

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.

Index terms: Bone marrow, abnormalities • Bone marrow, MR, 468.12141 • Foot, abnormalities, 468.833 • Foot, MR, 468.12141

This article has been cited by other articles:

				N. M. Major Role of MRI in Prevention of Metatarsal Stress Fractures in Collegiate Basketball Players Am. J. Roentgenol., January 1, 2006; 186(1): 255 - 258. [Abstract] [Full Text] [PDF]

				D. C. Moe, J. J. Choi, and K. W. Davis Posterior Subtalar Facet Coalition with Calcaneal Stress Fracture Am. J. Roentgenol., January 1, 2006; 186(1): 259 - 264. [Full Text] [PDF]

				L. Boxheimer, A. M. Lutz, M. Zanetti, K. Treiber, L. Labler, B. Marincek, and D. Weishaupt Characteristics of Displaceable and Nondisplaceable Meniscal Tears at Kinematic MR Imaging of the Knee Radiology, January 1, 2006; 238(1): 221 - 231. [Abstract] [Full Text] [PDF]

				S. C. Nelson and D. M. Haycock Arthroscopy-Assisted Retrograde Drilling of Osteochondral Lesions of the Talar Dome J Am Podiatr Med Assoc, January 1, 2005; 95(1): 91 - 96. [Abstract] [Full Text] [PDF]

				L Kroger, P Arikoski, J Komulainen, R Seuri, and H Kroger Transient bone marrow oedema in a child Ann Rheum Dis, November 1, 2004; 63(11): 1528 - 1529. [Full Text] [PDF]

				A. G. Bergman, M. Fredericson, C. Ho, and G. O. Matheson Asymptomatic Tibial Stress Reactions: MRI Detection and Clinical Follow-Up in Distance Runners Am. J. Roentgenol., September 1, 2004; 183(3): 635 - 638. [Abstract] [Full Text] [PDF]

				M. Zanetti, C. W. A. Pfirrmann, M. R. Schmid, J. Romero, B. Seifert, and J. Hodler Patients with Suspected Meniscal Tears: Prevalence of Abnormalities Seen on MRI of 100 Symptomatic and 100 Contralateral Asymptomatic Knees Am. J. Roentgenol., September 1, 2003; 181(3): 635 - 641. [Abstract] [Full Text] [PDF]

				K. Strobel, C. W. A. Pfirrmann, M. Zanetti, L. Nagy, and J. Hodler MRI Features of the Acromioclavicular Joint That Predict Pain Relief from Intraarticular Injection Am. J. Roentgenol., September 1, 2003; 181(3): 755 - 760. [Abstract] [Full Text] [PDF]

				T. J. Mosher Diagnostic Effectiveness of Gadolinium-enhanced MR Imaging in Evaluation of Abnormal Bone Marrow Signal Radiology, August 1, 2002; 224(2): 320 - 322. [Full Text] [PDF]