Edema of the bone marrow of the knee and spine: treatment

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  • 1Edema of the bone marrow: symptoms, treatment
    • 1.1What is hematoma?
    • 1.2Symptoms of edema of the bone marrow
    • 1.3Classification of hematoma of bones
    • 1.4Symptoms of edema of the bone marrow
    • 1.5Diagnosis of bone contusion
    • 1.6Treatment of edema of the bone marrow
    • 1.7Bibliography:
  • 2Trabecular Edema: Symptoms and Methods of Treatment
    • 2.1Causes and Symptoms
    • 2.2Diagnosis and treatment
  • 3Edema of the bone marrow (spine)
    • 3.1What is the edema of the bone marrow?
    • 3.2Clinical picture
    • 3.3Types of bone marrow edema:
    • 3.4Trabecular edema of the bone marrow
    • 3.5Edema of the bone marrow of the femur
    • 3.6Subchondral edema of the bone marrow
    • 3.7Aseptic edema of the bone marrow
    • 3.8Reactive bone marrow edema
    • 3.9Edema of the bone marrow of the tibia
    • 3.10Conjugation edema of the bone marrow
    • 3.11Perifocal edema of the bone marrow
    • 3.12Treatment of edema of the bone marrow
  • 4Edema of the bone marrow of the spine
    • 4.1Symptoms and manifestations
    • 4.2Causes
    • 4.3Types of edema
    • 4.4Trabecular edema
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    • 4.5Subchondral edema
    • 4.6Aseptic swelling
    • 4.7Reactive swelling
    • 4.8Spine
    • 4.9Thigh and tibia
    • 4.10Knee-joint
    • 4.11Radius
    • 4.12Diagnostics
    • 4.13Methods of treatment
    • 4.14Conservative treatment
    • 4.15Operative treatment
  • 5Trabecular edema of the femur and tibia, treatment of the knee joint
    • 5.1Causes
    • 5.2Clinical picture
    • 5.3Diagnostics
    • 5.4Types of edema
    • 5.5Trabecular edema of the bone marrow
    • 5.6Subchondral edema
    • 5.7Aseptic swelling
    • 5.8Reactive swelling
    • 5.9Edema of the tibia of the tibia
    • 5.10Conjuring swelling
    • 5.11Perifocal edema
    • 5.12KM knee
    • 5.13Edema of the bone marrow of the femur
    • 5.14Edema of the bone marrow medial condyle of the tibia
    • 5.15Therapy

Edema of the bone marrow: symptoms, treatment

Most people are familiar with the bruising that occurs when the muscles and soft tissues are injured. Nevertheless, not everyone knows that the bones can also have hematomas.

Contusions of bone tissue are serious and painful injuries, which usually occur within a few months, although with bruises of large bones it can take even more time.

© wiseGEEK: clear answers for general questions

What is hematoma?

The hematoma is formed when, when struck, the blood vessel is torn close to the surface of the skin. In this case, a small amount of blood enters the tissues under the skin.

The area of ​​impact acquires first a red color, and then it turns blue or purple, green and yellow-brown, and when the bruise heals, the skin becomes normal color.

Bruising can occur not only under the skin, but also deep in tissues, organs and bones. Deep bruises have no visible signs of bleeding, a bruise can cause severe pain.

In 1988, scientists discovered a condition called bone marrow edema. It was found that people with pain in the hip and knee joint changed bone marrow density on magnetic resonance imaging (MRI), this was not visible in x-rays.

The edema of the bone marrow is now called the "bone contusion" to reflect the traumatic nature of this condition. Contusion of bones is also sometimes called contusion or bruise of bone.

Changes in the bone marrow of bones can be caused by the following reasons:

Blood supply leads to stagnation of blood flow and causes severe inflammation.

Fluid inside the bone. In muscle injuries, fluid accumulates in the muscles and causes swelling. The bones are not able to swell, instead the fluid in the bones creates pressure, which leads to pain.

Reactive hyperemia - this occurs when the blood flow increases after a temporary stop.

Fracture: there may be a small crack in the layer of bone, just below the cartilage in the joint.

Trabeculae are septa that support fibrous tissue in the bone.


A complete bone fracture means that all bone trabeculae in this particular area of ​​the bone are damaged, which causes a rupture.


Hemorrhage of the bones is often described as a stage before fracture. In this case, only some of the trabeculae are violated.

Symptoms of edema of the bone marrow

Pain, which persists even after the disappearance of the hematoma;


Skin discoloration;

Pain in the joints near the area of ​​exposure;

Inflammation of the joints;

Stiff joint stiffness.

Pain associated with a bone injury lasts longer than with a soft tissue injury.

Classification of hematoma of bones

There are three types of bone hematoma:

Subperiosteal hematoma - blood accumulates beneath a fibrous membrane that covers the surface of the bone;

Interosseous hematoma, including bleeding and edema in the central cavity of the bone, where the red and yellow bone marrow is located;

Subchondral damage - bleeding and swelling occur between the cartilage and the bone below.

The type of bone contusion depends on where the damage occurs.

Subperiosteal hematoma mainly occurs after a traumatic blow to the bone. This is often found in the lower parts of the body.

Interosseous hematoma occurs with regular injuries. This type of bruise is mainly found in football players, basketball players and runners.

Subchondral lesion is caused by a compressive force. This type of bruise is more common in soccer and basketball.

Jumping on hard surfaces can cause all three types of bone hematoma.

Symptoms of edema of the bone marrow

Edema of the bone marrow is often observed in the knee joint, wrist, calcaneus, ankle and thigh. They often occur in sports injuries, falls, car accidents or when struck. Bone hematomas can also be caused by diseases such as arthritis.

A person can be at risk of a bone hematoma if he:

Participates in sports events;

Has heavy physical work;

Do not wear protective gear for sports or for work;

If he has osteoarthritis.

Diagnosis of bone contusion

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It is important to consult a doctor if there is a suspicion of edema of the bone marrow, as this can cause serious problems. The doctor can conduct a medical examination of the injured area, and if there is a suspicion of hematoma, an MRT is prescribed.

Treatment of edema of the bone marrow

Bone hematoma can be treated with rest, ice and pain medications.

The doctor can offer:

Rest of the injured limb;

Reduction of edema due to raising the injured limb above the level of the heart;

Application of ice several times a day;

Medicines to reduce pain and inflammation;

Wearing a bandage to limit movement.

It is important to avoid constant or strong pressure or heavy weight on the affected area. If the bone or joint does not have enough rest, the healing process may slow down and more damage may occur.

It is necessary to maintain a diet rich in calcium, vitamin D and protein. Smoking can delay bone healing.

Most bone bruises heal within a few months. In rare cases, in the absence of blood supply, aseptic necrosis of the bone may occur. If the bone dies, the damage is irreversible.

While bone contusions can not always be prevented, balanced nutrition, regular exercise, quitting, Limiting alcohol consumption and using protective devices during exercise will help keep your bones healthy.


  1. DeAngelis, Joseph P., and Kurt P. Spindler. «Traumatic bone bruises in the athlete's knee»Sports Health: A Multidisciplinary Approach 2.5 (2010): 398-402.
  2. Mandalia, V., et al. «Bone bruising of the knee"Clinical radiology 60.6 (2005): 627-636.
  3. Mandalia, V., and J. H. L. Henson. «Traumatic bone bruising-A»European journal of radiology 67.1 (2008): 54-61.
  4. Patel, Sonika A., et al.

    «Prevalence and location of bone bruises associated with anterior cruciate ligament injury and implications for the mechanism of injury: a systematic review"Sports Medicine 44.2 (2014): 281-293.

  5. Wilson, A. J., et al.

    «Transient osteoporosis: transient bone marrow edema?"Radiology 167.3 (1988): 757-760.

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A source: https://medicalinsider.ru/bolezni/otek-kostnogo-mozga-simptomy-lechenie/

Trabecular Edema: Symptoms and Methods of Treatment

Trabecular edema is the edema of the trabeculae (beams) of the bone marrow, which appears with inflammation in the bones, traumas.

The fluid retention in the bone trabeculae can speak of a bone fracture or a bruise, for example, a vertebra.

The condition is also observed with arthritis of the knee joint, when the tibial and femur are involved in the inflammation process. Excess fluid between the trabeculae causes a secondary impairment of blood circulation in the bone.

Causes and Symptoms

Trabecular edema is of three types:

  1. Vazogennye edema occurs after injuries and against the background of inflammation in violation of the integrity of the capillaries.
  2. Interstitial - edema of the intercellular substance of bone, represented by collagen fibers and mucopolysaccharides. Collagen fibers swell.
  3. Cytotoxic - bone marrow cells are swollen, namely, osteocytes, osteoblasts, osteoclasts. This is a more serious violation than the accumulation of fluid in the interstitium.

Vasogenic trabecular edema of the bone marrow with aggravation leads to accumulation of fluid in the intercellular substance. With a further violation of the outflow of moisture, there is edema of osteoblasts, osteoclasts and osteocytes.

Hyperhydration of the bone marrow occurs with fractures and bruises of bones, as well as with cancer, inflammation of the joints, for example, the knee.

The fluid accumulates in the bone tissue after surgery (jet edema), with overexertion in athletes (concussion of the knee joint).


Edema of the vertebral body leads to compression of the spinal cord and impaired circulation of cerebrospinal fluid (CSF), which also flows through the ventricles of the brain.


When swelling of the bones of the spine, there are symptoms from the side of the brain and spinal cord.

Neurological symptoms also include an inadequate response of pupils to light, hyperreflexia, or, conversely, the extinction of reflexes.

The patient is disturbed by the sensitivity of the limbs and / or their immobility is observed. From the spinal cord, the roots and plexuses of nerves that control the work of internal organs, such as the pharynx, the bladder, the intestine, etc.,

Deformation of the spinal cord leads to disruption of the impulses along vegetative and sensitive fibers that go to the organs.

As a result, patients with trabecular edema of the vertebrae experience delay or incontinence of urine, feces, difficulty in eating.

With inflammation or trauma to the cervical vertebrae, breathing and regulation of pressure, vascular tone may be impaired. With paralysis of respiratory muscles and loss of vascular tone, a lethal outcome is possible in the case of untimely diagnosis and treatment.

Edema of the bone marrow in the vertebrae may be aggravated by protrusions of the spinal discs.

With inflammation in the knee joints, edema of the femur and tibia is not as dangerous as a similar process in the vertebrae, and does not lead to death.

With gonarthritis and gonarthrosis, the condyles of the femur are involved in the process, as well as the articular surface of the tibia. This process is called subchondral edema.

With inflammation of the knee joint, symptoms such as swelling, redness, and local fever occur. Degenerative changes in arthrosis can lead to disability and the need to replace the joint.


For the removal of trabecular fluid stagnation during inflammation and degenerative changes of the knee joint, treatment of arthrosis and arthritis is necessary.


The edema of the bone marrow can have an aseptic character, in which there is no infection that led to inflammation, which happens with closed fractures and bruises. With open trauma with infection, septic inflammation and edema develop.

Diagnosis and treatment

The main diagnostic methods are magnetic resonance imaging and computed tomography. At neurological complaints at the patient (infringement of sensitivity and mobility of extremities) on MRT or KT reveal presence of a trabecular edema of vertebra or vertebrae.

In case of suspicion of degenerative processes in the knee joint, arthroscopy is used.

In gonarthritis, a diagnostic puncture of the knee joint is performed with the analysis of the synovial (intraarticular) fluid.

For the diagnosis of subchondral edema, a urinalysis on CTX-II (constituent elements of collagen of the second type) is recommended.

With injuries of the limbs, radiography of the bones is shown.

Treatment for trabecular edema of the vertebrae is an operation to decompress the spinal cord to restore its function, as far as possible. Postoperative rehabilitation is necessary, since with discomfort disability is inevitable.

Anti-inflammatory effect is potassium iodide, which helps to remove the edema of the bone marrow, regardless of the cause that caused it.

With inflammation of the knee joint, the treatment consists in the use of anti-inflammatory drugs of steroid and non-steroid origin. To remove the pain syndrome use non-narcotic or narcotic analgesics.


Degeneration of cartilage and bones during inflammation is somewhat inhibited by preparations based on cartilaginous tissue (Alfluton, Mukosat).


Treatment of arthrosis in advanced stages requires joint replacement.

Restoration of blood circulation and elimination of trabecular edema during bone inflammation is promoted by angioprotectors (Actovegin, Solcoseryl).

A source: http://OtekInfo.ru/oteki/organov/trabekulyarnyy-otek.html

Edema of the bone marrow (spine)

Swelling of the spinal cord or brain is a collective term. All processes that fall into this category are a particular pathology.

It consists in the accumulation of excess fluid in the body - more precisely, in its cells and intercellular space. This leads to an increase in brain volume.

The medical literature practically does not use this term. He does not have descriptions.

Earlier, pathology was called "swelling and swelling of the brain in which the main manifestations were squeezing and moving apart cells because of excess fluid.

This led to disruption of oxygen transport and metabolism, and cells died. But the "clean" formulation of the concept of "edema" is not to be found today.

What is the edema of the bone marrow?

Edema of the bone marrow is the process of increasing the fluids that are in the bone tissue. It is incorrect to consider the edema of the bone marrow causing problems. This is simply a nonspecific manifestation, and it can be detected using an MRI.

This formation appears because of any pathological process taking place in the hearth (o traumatic injury of bone beams is referred to as trabecular injury) or in close proximity to edema.

So, it appears as a consequence of damage to the cartilage of the joint with a violation of the subchondral plate.


Concerning the forecasts and recommendations, it should be noted that it is not the edema itself that is important here, but its causes. In addition, the functions of the joint and its other characteristics are important.


The edema of the bone marrow is the accumulation of fluid in the bone tissue. This is one of the nonspecific manifestations of some pathological process that goes on in the hearth. This phenomenon can be classified according to several features.

Among them is the prognosis of pathogenesis, according to which edema occurs:

  • Vazogennye, appearing because of increase in permeability of capillaries, for the reason of what begins the percolation of proteins and water into the so-called extracellular space with penetration through the walls vessels;
  • interstitial, appearing due to hydrocephalus;
  • cytotoxic edema of the bone marrow, which is a "swelling" of cells directly due to the accumulation of intracellular fluid. This, in turn, is a consequence of reduced metabolism, and the consequence of similar pathologies becomes a violation of the functioning of the cell membrane, accumulation in the cells of sodium, and after him and water.

Clinical picture

Edema can be of different types, but they have a standard clinical picture. So, the patient suffers from:

  • disorders of blood circulation, respiration,
  • impaired pupillary response.

All these are manifestations that threaten life.

You can mention the so-called preliminary syndromes - they include manifestations of the syndrome intracranial hypertension, which develops against the background of an intensive increase in the volume of fluid in the cavities of the skull. Given that the skull is a closed kind of space, the pressure of the liquid on the brain gets all the necessary conditions.

Symptoms of a bone marrow tumor are very serious. This is the most important organ that enters the hematopoietic system without which it is impossible to carry out the process of creating new blood cells. Recall that they automatically die.

It can be seen in the spongy substance of the bones, and in addition, in the medullary cavity. The organ promotes immunopoiesis, i.e. for the maturation of cells of the immune system, as well as for bone formation.

If its condition is normal - it contains a huge number of cells of undifferentiated, low-grade and immature type, which are commonly compared to embryonic cells.

They are unique, other bodies are not responsible for their lives.

It is easy to imagine how important the health of this body. So, for a certain focal symptomatology, the localization of edema in a separate part of the brain is clarified, because of the appearance of which there are malfunctions in the functioning of the affected area.

Types of bone marrow edema:

Types of bone marrow edema can be distinguished by a number of signs. Recall that this will determine which measures will be chosen to eliminate this pathology and its consequences.

Trabecular edema of the bone marrow

Trabecular edema of the bone marrow is the first signal about vertebral fracture. This is especially possible in case of a decrease in the height of the vertebral body with a fracture. If there is only edema - the presence of a vertebral contusion, the fracture is doubtful.

The best way to demonstrate the situation here will be diagnostic methods such as X-ray or CT, and the MRI procedure will help as an additional method.

This is because the pathology of soft tissue structures is diagnosed by MRI.


With trabecular edema, there should be an increase in fluid volumes in the bone tissue, where speech is not only about traumatic genesis, but also about the inflammatory process.


Treatment here will consist in taking potassium iodide, which has an anti-inflammatory effect. While the size of the protrusion is small, one should resort to treatment, regardless of its location.

It is necessary to prevent protrusion of the spinal cord and the development of myelopathy, for which besides medicamental treatment and physiotherapy prescribe gloefleksoterapiyu and exercise therapy.

Edema of the bone marrow of the femur

The edema of the bone marrow of the femur can take quite serious forms. Of great importance here is the reason for its appearance.

So, if he accompanies the disease osteomyelitis, the manifestations are quite severe. This is a complex process with the formation of pus.

It seizes bone and bone marrow, where bacteria of a harmful nature also spread, and requires complex treatment. In this case, edema is a consequence of the disease itself.

Also, this disease accompanies osteochondrosis, herniated intervertebral discs. They are established by means of MRI. The surgeon can determine the exact diagnosis.

Such edema may indicate a pathology of the bony protrusion in the femur. In this case, this bone is considered as a part of the knee, and in the disturbance of its functions it makes sense to worry - whether the patient has an edema of the bone marrow of this bone.

Subchondral edema of the bone marrow

Subchondral edema of the bone marrow can turn into an irreparable trauma for the whole organism. Literally the term "subchondral" means "subchondral".

As you know, bone consists of certain elements, among which are cartilage. This element is brittle and more elastic in the background of the skeleton.

Subchondral changes in the bone marrow can be determined using MRI and C-terminal cross-linked telopeptides of type II collagen (CTX-II).


They are taken from the urine of the sick.


Undoubtedly, analyzes are made and taking into account the composition of the blood, since the cartilage is directly related to the state of the bone marrow, involved in the blood formation.

The dynamics of bone marrow disorders sometimes occurs in just 3 months. The less this pathology - the less the rate of decay of cartilage.

Aseptic edema of the bone marrow

Aseptic edema of the bone marrow begins with such parts of the body as the head and neck of the femur. This is the so-called early (reversible) stage. It is identified long before the printout of X-ray symptoms.

If you watch MR-tomograms, you can see the following manifestations. It takes the form of areas of reduced intensity of the MR signal with respect to T1-VI and a higher one for T2-VI.

This is clearly seen in comparison with the normal image of the fatty bone marrow.

To fully explain the situation with this symptom, you need to use a sequence with suppression of adipose tissue.

Aseptic pathology can be distinguished by hyperemia, increased local temperature, swelling, pain, impaired function.

It is accompanied by the development of a serous, serous-fibrinous, fibrinous variety of exudate.

Inflammatory edema of this species can signal the development of aseptic inflammation.

Reactive bone marrow edema

The reactive edema of the bone marrow develops in the tissue in the form of a reaction, the cause of which is any intervention. To such it is possible to carry, for example, a postoperative field.

The reactive edema along with the pain syndrome often appears after the depression. Such patients undergo physiotherapy for 3-10 days.

To remove such a swelling, it is often recommended a controlled load course. Rehabilitation is helped by a series of exercises - such as alternating positions.


If there is a pronounced pain syndrome - it makes sense to prescribe analgesics.


In particular, it helps with a similar edema that arose due to fracture of the hip bone in conditions of SCR.

Edema of the bone marrow of the tibia

Edema of the bone marrow of the tibia is rarely accompanied by revealed bone-destructive changes.

The zones of edema of the bone marrow of this type are revealed in the areas of the medial condyles of the femoral and tibial bones. Their size depends on the reason for their appearance.

So, at a sports loading they appear because of traumas and happen in the sizes, х, sm, etc. Their external symptoms are similar to osteosclerosis.

In this case, in the joint gap pathologies are not always detected.

As we have said, a symptom such as a bone marrow edema often accompanies other diseases, especially in the absence of treatment. So, he accompanies the contusion of the areas of the bone marrow, synovitis.

Such traumas appear under certain circumstances - for example, sharp bends of the trunk. Acute pain may not be, especially with surgical treatment and minor trauma.

The leg is unbent and bends with varying degrees of difficulty.

Conjugation edema of the bone marrow

Contusional edema of the bone marrow is detected by standard methods, such as MRI.

Diagnosis is based on several steps, among them - personal consultation of the orthopedist, whose profile is the problems of the knee joint.

It will be necessary to compare the data of the clinical examination and the results of MRI. Perhaps in the presence of symptoms:

  • Painful character.
  • Jamming.
  • Instability.
  • Edema of the knee joint

It is necessary to consider, in what situations the formation of a concussion edema of the bone marrow of the condyles of the femoral and tibial bones is actual. Often they accompany the MR picture with a ruptured anterior cruciate ligament, and not only.

Recommendations for treatment are different. If the case is serious - recommend arthroscopic autoplasty of the anterior cruciate ligament and procedure for resection of the lateral meniscus.

The heavier the injury, because of which this edema appeared, the more difficult the treatment. Often, the treatment of edema begins, for example, after the removal of gypsum.

It should be remembered that if the bones after the fracture have merged incorrectly, then we will have to deal with several problems simultaneously.

Perifocal edema of the bone marrow

Perifocal edema of the bone marrow is formed due to the increase in extracellular space due to accumulation of fluid in it.

Her admission comes from damaged glial cells.

The cell membrane has permeability, this refers to the membrane of the capillary endothelium in the zone around the lesion.

To determine the prevalence of the perifocal edema zone, not only the degree is measured by increasing the water content in it. This formation is influenced by regional demyelination of white brain fibers.


Depending on the degree of demyelination, the content of lipids in said perifocal zone is determined. This indicates the expression of disturbances in the processes of oxidation and phosphorylation with the formation of cerebral edema.


This type of edema can form when a certain amount of plasma proteins enter the white matter of the brain and form their connection with glial elements.

There is an increase in further fluid intake - it fills the perivasal space due to the osmotic gradient. A similar mechanism is characteristic for fluid intake from the cerebrospinal fluid system. Favorable environment for the development of tumors are lesions.

Edema can occur around foci with different sizes, up to 1 cm. Depending on the complexity of the disease, surgical intervention is not always required.

Treatment of edema of the bone marrow

Treatment of the edema of the bone marrow is based on a number of important factors:

  • the reason for its occurrence;
  • degree of manifestations of the pathological process;
  • character and degree of the role and influence of education on the functioning of the joint.

Elimination of the edema of the bone marrow is a rather difficult task. To solve it with great care, even highly qualified specialists. Self-medication is excluded.

Particularly the situation is complicated by the fact that any wrong action often leads to a fatal outcome. When there is a period of exacerbation - the doctor should take care of restoring the level of cerebral perfusion pressure.

It is customary to call it the CPD. Then it will be possible to ensure normal blood circulation and the supply of the required substances to nerve cells.

Normal maintenance for the edema of the bone marrow is an increase in intracranial pressure, followed by a sharp drop in the level of CPD.

To reduce the high level of pressure, they resort to help:

  • Maintenance of oxygenation.
  • Elimination and prevention of pain syndrome.
  • Elimination of cramps.
  • Maintain body temperature within normal limits.
  • Prescribing diuretics to the patient to remove excess fluid.
  • Moderate hyperventilation.
  • Elimination of the causes that led to the violation of normal outflow of fluid.
  • Normalization of the volume of the spinal cord, which will help the course of drugs forced diuresis, necessary to regulate electrolyte metabolism.

It is imperative to control the water-electrolyte balance. When organizing the treatment of the edema of the bone marrow, it is very important to organize glucocorticoid therapy.

Its task is the stabilization of cell membranes. This prevents the accumulation of catecholamines in damaged cells and tissues.

Excellent showed themselves membrane protectors, which are also called "nootropics."

All these are components of conservative treatment. What it takes to bring the desired result? Perhaps, surgical treatment is required.


With cerebral edema are struggling through trepanation of the skull, this will help lower the level of intracranial pressure. Through trepanation, the skulls are successful in decompression surgery.


It consists in the removal of the bone flap by surgical methods.

Edema of the bone marrow is a serious problem. At its treatment it is necessary to cope with complex problems. The treatment should be chosen quickly. It is unacceptable to linger in the decision of this issue, it can cost the patient a life.

Zhuravlev Ivan Ivanovich, an osteopathic doctor, a bone-opener

A source: http://kakbyk.ru/otyok/otek-kostnogo-mozga-pozvonochnika/

Edema of the bone marrow of the spine

Edema of the bone marrow is a symptom most often caused by infection or trauma, is a kind of protective reaction of the body and manifests itself as fluid retention in cells. To get rid of this disease state it is necessary to identify and treat its cause. What is it, what can it be called and how to remove the edema of the bone marrow?

Symptoms and manifestations

Bone marrow is a soft tissue of the internal cavity of the bone, which participates in the preservation of stem cells and the creation of new blood cells (hematopoiesis). This component is more localized in the sternal, femoral bones, vertebrae, ribs and bones of the cranium.

Edema of the bone marrow can manifest itself in different ways. Symptoms often depend on the location of the lesion and the cause of its occurrence.

If the problem is caused by a bruise or other mechanical damage, a person often experiences pain, first a sharp and then aching pain.

Puffiness can also cause blood circulation disorders, numbness and cold extremities, as if "arms and legs" were "cut off." And if the lesion is localized in the lumbar region, then the lower extremities suffer, in the thoracic and cervical - both of them.

Swelling of the bone marrow in the thoracic spine and ribs can be manifested by difficulty breathing.


Often, puffiness provokes injuries. Among them are the following:

  • bruises;
  • fractures closed and open, with or without offset;
  • sprain;
  • damage to connective tissue;
  • rupture of tendons;
  • inflammation of the synovium.

In addition, the accumulation of fluid in tissues can be observed in such diseases:

  • osteoarthritis (joint wear);
  • osteochondrosis (involvement of intervertebral discs);
  • osteoporosis (increased brittleness of bones);
  • aseptic necrosis (necrosis of tissue);
  • rheumatoid arthritis (chronic inflammation of the joints);
  • ischemia (weakening of blood flow);
  • benign and malignant neoplasms.

Types of edema

Trabecular edema

Trabecular edema of the bone marrow is the flow of trabeculae (rungs), areas of spongy substance, between which the bone marrow is located. This condition most often speaks of a fracture or a severe bone injury, as well as inflammation, for example, about arthritis or osteoporosis of the knee.

Most often this kind of edema is manifested by painful sensations below the lesion, complications can be very dangerous.


Possible violation or disappearance of the reflex activity below the site of damage. Symptoms can also be problems with blood circulation and breathing.


If the trabecular edema is not treated for a long time because of the excess of accumulating fluid, an increase in intracranial pressure may be observed.

Subchondral edema

Subchondral or subchondral edema of the bone marrow without treatment can lead to irreversible consequences, up to the destruction of cartilage.

This pathology also occurs most often due to trauma or inflammation.

Edema here is manifested by pain, tightening and restriction of mobility of the neighboring joint.

Subchondral changes can be detected using MRI, as well as by making urine and blood tests.

Aseptic swelling

Aseptic bone marrow edema mainly begins with the head and neck of the femur. It can be identified by eye, even without resorting to such methods of research as MRI.

Hyperemia (redness), a local increase in body temperature with visible swelling, pain - all this indicates the presence of this kind of swelling.

Aseptic edema is accompanied by the development of exudate (serous, fibrinous and serous-fibrinous type), fluid released by small blood vessels in the tissue or body cavity.

Reactive swelling

The reactive edema of the bone marrow, as a rule, develops after any surgical intervention. Very often, such swelling with pain syndrome occurs after the treatment, the forced correction of deformity or the incorrect position of the bones.

This edema is removed with the help of physiotherapy procedures and controlled loads with alternating positions. The rehabilitation process usually takes up to ten days. In severe pain, analgesics are prescribed.

If you do not start treatment on time, there may be dangerous consequences. Complications may include diseases such as synovitis and concussion.


Edema of the bone marrow of the spine often occurs with injuries, problems with blood circulation, certain diseases (for example, osteochondrosis), as well as tumorous neoplasms. Flow can occur locally in the lesion of one or more vertebrae, or affect the entire spinal cord.

A slight swelling accompanied by pain, a sense of discomfort and stiffness.

For more serious injuries, symptoms such as decreased sensitivity, numbness and coldness of the limbs, a feeling of "crawling crawling."

With localization in the cervical region, there may be problems with breathing and swallowing.

If you do not treat this pathology, the consequences are very serious, beginning with a partial violation of free movement of limbs and reducing reflexes, and ending with disability. Subchondral edema of the vertebrae leads to destruction of the cartilage, which, in turn, promotes deformation of the intervertebral discs.

Thigh and tibia

Contusions of fractures and other types of injuries are the most common causes of edema of the bone marrow of the femur and the tibia. Most of the swelling occurs in the areas of the medial condyle of these bones.

In this case, a person experiences pain, a feeling of "bursting" of a large bone of the thigh or lower leg, bleeding may occur. Later, there is a violation of the musculoskeletal function.

When the hip is dislocated, in addition to pain and swelling, the injured leg may be turned outward.


Another dangerous condition that provokes puffiness is osteomyelitis (inflammation of the bone marrow).


The disease occurs due to trauma or hematogenous way, when the infection comes from outside.

In acute osteomyelitis, there is formation of abscesses, high fever, intense pain, and in later stages - necrosis of the bone. The tumor grows very quickly, it seizes neighboring sites.


Another common site of bruises is the knee joint.

Such injuries can be obtained by practicing sports, in road accidents, jumping from a height, for example, with a parachute and with other active actions.

Injuries to the knee joint can have the same serious consequences as hip injuries. Basically, this limitation of mobility, lameness and a decrease in the length of the limb.

Edema of the bone marrow of the knee joint, which is a frequent symptom of such lesions, is mainly localized in the femoral condyle area and strongly disrupts hematopoiesis. What is characteristic, with a knee injury, the process is localized only at the site of the injury, without affecting other bones.


The edema of the bone marrow in the diaphysis of the radial bone is often provoked by some kind of trauma, mainly a fracture with a displacement and without. The elder people, especially in the winter, suffer the most from such injuries, and athletes.


If there is a suspicion of swelling of the bone marrow, doctors use radiation methods of diagnosis. Here are the main ones:

  • Magnetic resonance imaging (MRI) is the most informative method for studying soft tissues, allows you to describe the size and location of the tumor;
  • Computed tomography clearly shows damage to the bone apparatus, but to detect the edema itself is ineffective, since it does not reflect the state of soft tissues;
  • X-ray reveals only severe bone injuries.

Methods of treatment

To remove puffiness, you must first identify the cause of its appearance.

Therapy will be aimed at eliminating the underlying disease, reducing the pain syndrome and actually reducing the swelling itself.

Depending on the severity, diagnosis, the doctor may prescribe conservative or surgical treatment.

Conservative treatment

Conservative therapy can include the use of medicines and physiotherapy procedures. Appoint such medicines:

  • anesthetics (for example, analgesics such as Ketanov, Tramadol);
  • diuretics;
  • vasoactive drugs that dilate the blood vessels and restore blood supply to the affected tissues;
  • means, removing inflammations, namely non-systemic glucocorticosteroids or potassium iodide (Budesonide, Prednisilon);
  • drugs to accelerate the regeneration of nerve cells (for example, B vitamins);

In addition to medicines, the doctor can appoint:

  • physiotherapeutic procedures;
  • therapeutic gymnastics;
  • Special mode with reduced load on the damaged area.
  • wearing various supporting corsets, bandages to maintain the spine and reduce the load on it.

In light diseases, with the permission of a doctor, folk methods can be used. For example, to remove the swelling of the bone marrow of the knee joint, the treatment can include compresses and warm baths with herbal decoctions.

Operative treatment

To an operative intervention resort in case, if medicamental therapy has not given results. In addition, with certain types of injuries, when it is necessary to remove bone fragments, or for neoplasms, surgery may also be necessary.

Edema of the bone marrow is not an independent disease, but a symptom of any inflammation or trauma.

Identify the cause and remove swelling in the shortest possible time to avoid irreversible effects.

Therefore, in case of suspicion of a bone marrow injury, it is better to go to the hospital as quickly as possible and undergo a diagnosis.

A source: https://otekimed.ru/obshhie/kostnogo_mozga.html

Trabecular edema of the femur and tibia, treatment of the knee joint

The human body is a single whole, there are no organs and systems that function separately from each other. A particularly close relationship becomes apparent after the traumas and illnesses.

General disorders or local injuries in humans are expressed by certain signs, one of the first is edema.

It can not be considered a separate disease: it is a symptom that accompanies other diseases and is formed due to excessive accumulation of fluid in the organs and the intercellular space.

Bone marrow (CM) occupies an important place in the human hematopoietic and immune system. It is located inside tubular bones, sternum, ribs, vertebrae, in pelvic and skull tissues. Any deviations from normal work affect the general condition.


Factors contributing to the formation of edema:

  • presence of an infectious agent;
  • knee injuries, dislocations and subluxations with displacement;
  • ruptures of tendons and ligaments;
  • hemorrhage, impaired blood supply;
  • diseases of the musculoskeletal system ─ osteomyelitis, osteoarthritis;
  • oncological neoplasms.

Clinical picture

With prolonged structural changes, swelling and moderate pain are observed.


MRI (magnetic resonance imaging) and CT (computed tomography) are considered objective and necessary methods of examining patients.

MRI ─ the use of magnetic fields and radio waves makes it possible to obtain a high-quality image, during the procedure the patient is not exposed to radiation, so this survey is safe for human organism.

CT imposes multilayer application of X-rays, on the resulting image it is possible to examine the area under investigation from all directions with a special accuracy - up to a millimeter.

Arthroscopy is the minimal invasive method, it is prescribed for degenerative processes in the joints. Through small incisions, an arthroscope is inserted, allowing the surgeon to see the entire structure of the damaged joint on the screen.

Puncture of the joint (arthrodesis) ─ the method is used in medicine with a diagnostic purpose and therapeutic purpose. With the help of a puncture, joint fluid is taken for examination, revealing the causative agent of the infectious process.

When fractures of the extremities show radiography, also to clarify the diagnosis is recommended to submit a biochemical analysis urine on CTX-II (fragments of type II collagen, the main components of the cartilaginous tissue), general laboratory tests of blood and urine.

Types of edema

At classification pay attention to the reasons of occurrence, features of a pathogeny and a course of illness.

For reasons of appearance, swelling is noted:

  • tumor;
  • toxic;
  • traumatic;
  • hypertensive;
  • postoperative;
  • ischemic;
  • inflammatory.

By origin distinguish edema:

  • Cytotoxic ─ disturbed metabolic processes in cells. Appear as a result of oxygen starvation, toxic effects, brain ischemia. If the circulation is normalized within 6-8 hours, the effects of the edema are reversible.
  • Vazogennye ─ arise with increased permeability of capillaries, resulting in fluid from the vessels goes into the intercellular space. Characteristic for injuries, inflammations.

Depending on the course of the disease divided into the following varieties:

Trabecular edema of the bone marrow

Trabeculae are represented by the contents of strands, plates and partitions, are formed from connective tissue, including collagen substance, serve as the strengthening basis of the skeleton.

Subchondral edema

It is formed as a result of damage to the cartilaginous tissue - a fragile component of the skeleton. Its violations bring irreparable harm to human health.

The dynamics of the disease is characterized by a rapid current: in just 3 months there is a destruction of the cartilage, so it is important not to delay the treatment.

The examination consists of MRI and urinalysis at CTX-II.

Aseptic swelling

There is redness, swelling, fever, pain, perhaps limb dysfunction. Effective treatment assumes a favorable outcome of the disease.

Reactive swelling

Occurs after surgery, accompanied by pain syndrome.To eliminate the edema for the rehabilitation period, moderate loads are added in the form of alternating physical exercises and physical procedures.

Edema of the tibia of the tibia

Disturbances are observed in the medial condyle of the femoral and tibia. External symptoms are similar to osteosclerosis, damage in the joint gap may not manifest.

Conjuring swelling

The pathological process occurs in the knee after injuries, accompanied by rupture of the anterior cruciate ligament. When diagnosing a physician, the external symptoms and MRI data are taken into account, in some situations arthroscopic autoplasty is required.

Perifocal edema

As a result of accumulation of fluid, formed due to damage to nerve cells, there is an increase in the intercellular space. Edema occurs in the affected area up to 1 cm.

KM knee

To the development of degenerative changes of the joint in question lead to excessive physical exertion, people who lead an active lifestyle suffer more often.

If the landing fails, the injury is not seriously perceived, but quite often there are damage with the destruction of the patella, resulting in edema of the bone marrow of the knee the joint.

With trabecular edema of the knee, pain is felt, swelling is observed. If the edema persists for a long time, the patient reduces the length of the thigh and tibia, a decrease in cartilaginous tissue occurs, against this background claudication occurs.

Edema of the bone marrow of the femur

Occurs with osteomyelitis, a purulent process is attached, which affects the part of the musculoskeletal system under consideration and the brain. The diagnosis is established by means of MRI. To treat with complex therapy.

Edema develops from the resulting open trauma, when the pathogen enters the wound. Hematogenous infection is recorded from the internal purulent foci of inflammation, provoking the disease of osteomyelitis.

The course begins acutely: body temperature rises, pain appears without specific localization, movements become limited, spontaneous turning of the limb occurs inward.Phlegmons form with the further dying of bone tissue, by 3-4 weeks on the photographs are visible limited necrotic areas, which subsequently require surgical removal.

Edema of the bone marrow medial condyle of the tibia

It arises from damage to the integrity of the bone. There is a strong pain below the knee, visually observed puffiness of the soft tissues, there is a feeling of pressure in the bone, it is impossible to walk on foot when walking.


Treatment consists in reduction of pain syndrome, prevention of destruction of CM, restoration of functions of the damaged site and normalization of blood circulation.

Therapeutic measures should have an integrated approach and include different drugs:

  • prescribe painkiller, if necessary, supplement with potent narcotic drugs;
  • for the treatment of the inflammatory process, antibiotics, potassium iodide preparations, hormonal drugs (Prednisolone);
  • to improve blood supply intravenously, Trental, Actovegin;
  • pronounced edema requires the intake of diuretics;
  • when chondroprotective tissue is destroyed;
  • intramuscular injections of vitamins of group B are connected for restoration of nervous system;
  • by indications recommend compliance with bed rest or, if possible, restrict movement with crutches, wearing a bandage;
  • adjust the diet by eating more foods rich in calcium and vitamin D;
  • locally apply medicinal fiz.protsedury, under the supervision of a physician-rehabilitologist is performed LFK.
  • Surgical operation is indicated in extreme cases.

The rehabilitation period until full recovery lasts several months. It is important to follow all the prescriptions of the doctor to avoid serious complications that are irreversible.

A source: http://NogiNashi.ru/sustavy-i-kosti/simptomy-i-lechenie-otekov-bedrennoj-i-bolshebercovoj-kosti.html

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