Correlation Between Patterns of Bone Marrow Edema and Their Associated Soft-Tissue Injuries, as seen on Magnetic Resonance Imaging of Knee joint in Patients with a Recent History of Trauma

  • Archana Bhatnagar Mahatma Gandhi Memorial Medical College and Associated Hospitals, Indore, Madhya Pradesh, India
  • Bhagyashree Rathore Mahatma Gandhi Memorial Medical College and Associated Hospitals, Indore, Madhya Pradesh, India
Keywords: Bone bruise, Bone marrow edema, Magnetic resonance imaging knee, Musculoskeletal, Trauma


Introduction: Bone bruise or bone marrow edema is a common innocuous finding in magnetic resonance imaging (MRI) knee of patients with trauma. The pattern of bone marrow edema provides insight into the mechanism of injury which, in turn, helps to evaluate the injuries with a more discerning eye. Five basic mechanisms of knee injury which are commonly seen in MRI scan of knee trauma patients are pivot shift, dashboard injury, hyperextension, clip injury, and lateral patellar dislocation. Each of these mechanisms causes characteristic bone marrow edema patterns and has associated soft-tissue injuries, following the musculoskeletal biomechanics.
Aim: The purpose of this study is to assess the correlation between bone marrow edema patterns and associated soft-tissue injuries.
Settings and Design: This is a cross-sectional study of 200 patients conducted at the Department of Radiodiagnosis and Imaging, MGM Medical College and Associated Hospitals, Indore.
Materials and Methods: MRI of 200 cases of recent knee injury was analyzed to determine bone marrow edema pattern. The pattern of edema and soft-tissue injuries was plotted and analyzed to see a significant correlation.
Statistical Analysis Used: Variables were expressed as percentages and comparison was done by Chi-square analysis. Two-tailed P < 0.05 was considered statistically significant.
Results: Significant correlation was seen between pivot shift injury and anterior cruciate ligament (ACL) tear, pivot shift injury and medial meniscus tear, dashboard injury and posterior cruciate ligament (PCL) tear, lateral patellar dislocation and medial patellofemoral ligament (MPFL) tear, and clip injury and medial collateral ligament (MCL) tear. Pivot shift was the most common bone marrow edema pattern, accounting for 55.5% of cases and hyperextension was the least common pattern, seen in only 3% of cases.
Conclusion: The pattern of bone marrow edema can provide a road map to associated soft-tissue injuries which assist in finer evaluation and can help in creating better patient management outcomes.

Author Biographies

Archana Bhatnagar, Mahatma Gandhi Memorial Medical College and Associated Hospitals, Indore, Madhya Pradesh, India

Associate Professor, Department of Radiodiagnosis and Imaging

Bhagyashree Rathore, Mahatma Gandhi Memorial Medical College and Associated Hospitals, Indore, Madhya Pradesh, India

Senior Resident, Department of Radiodiagnosis and Imaging


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