Bone Abstracts

Background: Bone marrow edema (BME) is a localised bone lesion. We hypothesize that structural bone alterations increase the susceptibility to BME. Aim of this study was to analyse bone micro structure, bone mineral density (BMD) and serum fasting bone turnover marker (BTM) values in patients with BME.

Methods: We compared 14 nonosteoporotic patients (43.7±19.2 years) with atraumatic BME of lower limb to 35 age-matched healthy controls (HC). HR-pQCT examinations of distal tibia as well as DXA measurements of spine and hip, and serum examinations of BTM were performed.

Results: Areal BMD/BTM: BMD was in osteopenic range. All subjects presented no differences between the groups.

HR-pQCT-tibia: BME patients compared to HC had increased total bone area (TotalArea) (773.88±238 vs 659.19±113 mm², P< 0.05) and increased trabecular area (TrabArea) (689.89±238.25 vs 555.74±109.05 mm², P<0.01), lower density of the compacta (Dcomp) (809.19±65.78 vs 870.64±74.49 mgHA/ccm, P< 0.01) and diminished average bone density (D100) (245.25±46.50 vs 286.98±64.38 mgHA/ccm, P<0.05).

Intracortical porosity (Ct.Po) of patients with BME was significantly higher (8±1.4 vs 5±0.3%, P<0.05) and cortical thickness (Ct.th) (0.88±0.24 vs 1.09±0.31 mm, P< 0.05) was reduced. Trabecular thickness (Tb.th) (0.07±0.01 vs 0.08±0.01 mm, P< 0.05) was decreased, whereas the number of trabeculae (Tb.N) (1.83±0.29 vs 1.74±0.29 I/mm, P=0.19) did not differ.

Conclusion: Our data suggest that altered structural properties at cortical and trabecular compartments contribute to the susceptibility to BME. An increased bone area is in contrast to reduced bone density, and an enhanced cortical porosity seems to be combined with reduced cortical and trabecular thickness. This impairment might be responsible for the development of atraumatic BME and our findings contribute to its understanding and treatment.