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Bone Marrow Edema, is this it!

 

   


Northerner

Mar 15, 12 6:54

Post #1 of 22 (9566 views)
Bone Marrow Edema, is this it! Quote | Reply


After some weeks with tenderness and mild stinging on the medial part of left knee around Christmas last year Iím now finally diagnosed with bone marrow edema in the medial femur condyle, posterior.
So from being competitive in my age group two plus months ago my activity is now reduced to swimming, very light and easy cycling and some strength training on upper body and instructions from both the physiotherapist and doc about total rest of the injured leg!
I can live with that for a while but do to pain even when walking I begin to believe that ďits game overĒ
Donít get me wrong Iím not trying to make it looks like the world is falling apart, (Iím through that stage) but Iím not a ďspring chickenĒ anymore and to more I read up on bone marrow edema to more it seems as this is not only overuse but also age related and by that probably even harder if at all possible to recover from!
Anyone had this kind of injury and recovered, any treatment, exercises, whatever which have helped except from the dreadful word rest?

Thanks and Regards
Northerner



jasondubose

Mar 15, 12 8:25

Post #2 of 22 (9492 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

hey man, that sucks to hear, especially now that it's starting to warm up. How long did they say you'd have to rest? I impacted my 2nd metatarsal and it took 5 months before i was able to do any workouts again due to the location and nature of the fracture. my first run back was absolutely filled with joy... at 200 lbs and 11:30min/mi pace. i'm back to averaging 7:30's on my tempo stuff now. Not sure that's any consolation or even relevant, but just wanted to offer my experience with having to "rest".


-Jason
______________________________________________
Is that all you've got? Are you sure?


nickwisconsin

Mar 15, 12 8:39

Post #3 of 22 (9464 views)
Re: Bone Marrow Edema, is this it! [jasondubose] [In reply to] Quote | Reply

Does your doctor think this indicates a stress fracture? Bone marrow edema in and of itself is not that big of a deal. Hell, you could probably do an MRI of the feet of all the members of this forum and find a lot of people that have some degree of bone marrow edema just from being runners. I can't imagine this is a doom and gloom proposition. Talk to your doctor and ask questions. Figure out what the problem could be mechanically or training wise. Take some time off of impact and swim, bike and water run. Try running again in a few weeks.


jasondubose

Mar 15, 12 8:42

Post #4 of 22 (9458 views)
Re: Bone Marrow Edema, is this it! [nickwisconsin] [In reply to] Quote | Reply

oh yeah, to second what nick said...

if i were to do it over again, i would 1) watch my diet while i'm having to rest and 2) find SOMETHING physical to do. my first run was something i was thankful for. over the next month or two i wished i'd managed my weight and fitness better instead of being a fatty mcgoo and eating those icing-filled cookies from Kroger.


-Jason
______________________________________________
Is that all you've got? Are you sure?


Northerner

Mar 15, 12 18:47

Post #5 of 22 (9326 views)
Re: Bone Marrow Edema, is this it! [jasondubose] [In reply to] Quote | Reply

Thanks for replying.
Doc says nothing about Stress fracture. However every time I Google Bone marrow edema, stress fracture comes up!
MRI show ďpronounced bone marrow edema medial femur condyl subcorticalt, posterior. No fracture or osteonecrose. Meniscus, ligaments and side ligaments are normal, Chondromalacia patella grade 2 central, physiologically intraarticuler amount of fluid.Ē
Doc / Physiotherapist say minimum 12 weeks rest. Doc not a sports medic but my physiotherapist works for the National athletic team so should know what he talks about!
However I will get a second MRI soon and contact a sports medic.
Regards
Northerner.


rbar

Mar 15, 12 20:53

Post #6 of 22 (9274 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

 
Bone marrow edema just doesn't show up for no reason. That is an unusual location for a stress fracture. If there is no recent trauma avascular necrosis is a possibility. At least there is no internal derangement, meaning the ligaments, tendons and menisci are normal. I would exercise as much as the pain allows you to. You won't do any serious damage to anything by exercising, just may delay healing a little. I would think swimming and biking would be tolerated alot better than running. Aqua running, as unappealing as that is, would likely be fine too.


Northerner

Mar 16, 12 3:01

Post #7 of 22 (9221 views)
Re: Bone Marrow Edema, is this it! [rbar] [In reply to] Quote | Reply

Thanks for your reply!

What is avascular necrosis?
The only trauma I know about to the affected knee is flying over the handlebars once, but thatís more than 12 years ago and have never given me any pain running or biking and was just a small scrape in front of knee when it happen. The left leg (with the edema) has until now always been "the healthy one"
I have however LLI, the left is approximately 5-6mm longer than the right but I have always believed that the LLI is worst for the short leg and live constantly with a tight ITB in that leg.

Northerner.


lopott

Mar 16, 12 4:48

Post #8 of 22 (9184 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

Dead bone


rbar

Mar 16, 12 5:28

Post #9 of 22 (9157 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

Bone marrow edema from trauma 12 yrs ago would be long gone by now. Sounds like you don't have enough degenerative change to be the source of the edema either. Avascular necrosis is dead bone as stated, basically the bone dies because blood supply has been disrupted. There are many causes, one of which is "no known cause". This is unrelated to the IT band. Good luck to you


RCope

Mar 16, 12 5:47

Post #10 of 22 (9144 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

I see "bone marrow edema" frequently in my practice. It's better to call it a "stress reaction" in your setting. There's a good overview here: http://www.drpribut.com/...stress_fracture.html
Good luck and it's unlikely that it's "game over".


Northerner

Mar 17, 12 0:26

Post #11 of 22 (9067 views)
Re: Bone Marrow Edema, is this it! [RCope] [In reply to] Quote | Reply

Hi and thanks for the link.

I had a new conversation with the physio yesterday and when I mentioned that every time I Google bone marrow edema, stress fracture comes up he told that stress fracture is to stretch the diagnosis but used words similar to what Dr. Pribut says, i.e. repetitive stress Injury. He did not believe it was any other contributing factor to the injury than overuse over long time and the usual training errors and biomechanical reasons but couldnít totally eliminate that factor.

He would not give me an exact recovery time but said that as long as I stayed away from running and/or walking for exercise, strength training as squats, leg extensions, lunge etc it should under normal circumstances heel.
When I asked about riding he said that even if riding have some impact on the injury it was minimal to the movement and impact when running and walking and that riding would help to keep the blood circulation going but told me to ride with moderate intensity.

Thanks & Regards
Northerner.


mrtkarabatur

Jun 4, 13 8:44

Post #12 of 22 (7355 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

Hello everyone,

I am having the same problem in my knee, bone marrow syndrome with a second recurring. Since last January 2013, I am having this problem. I had a surgery of the marrow is removed out cleanly, then after 3 months I was feeling better and started walking. Then it recurred again. (since recurrance, after 2 weeks I started to rest again.) Now I am having an avascular necrosis at my knee bones. Apart from the pain and disability of walking; I am really concerned about my dying bones. My doctor said, the marrow is moving through my bone and causing pains in different places this time. Also my bone is dying, so I have to rest and use the leg rest(under my arm pits) all the time for about 40 days.

My questions are:
1. is there any other treatment rather than just resting? Any extra care shall I need?
2. the dead bones, do they generally get alive and come back normal?
3. is there any food I should eat to rapid the reproduction of my bone cells to make it alive again?
4. what are my chances for a recovery? Am I gonna be better again? If yes, how long would it take generally?
5. I hope I do not need but, if I need a protesis, is that surgery a hard one and after the protesis, how my life is going to be limited and in what ways?
6. Other suggestions?


Thanks in advance,
Regards


Northerner

Jun 5, 13 1:05

Post #13 of 22 (7249 views)
Re: Bone Marrow Edema, is this it! [mrtkarabatur] [In reply to] Quote | Reply

I think the only words I can use about bone marrow edema are what my orthopedic doctor said; it is some sh...t because there are no treatment available and as he said a fracture is in fact easier to diagnose and treat because then we have something to point a finger on and we can more exactly prescribe correct treatment.

I personally got better last year and had a new MRI in September 12 which showed improvements so slowly started run again in November and even got with me a Triathlon in December and a couple of road races in January/February this year and things started to look brighter, but then in April working out of town for 2 months with too little rest and was generally tired just of working it flared up again so now Iím back to scratch but it feels worse this time!

I have tried ultrasound on my knee but canít say it helped anything!

As supplement I take prescribed Calcigran Forte (different name in different countries) but its 1000mg calcium and 800IE vitamin D and top it up with 1600mg Glucosamine daily plus a protein drink a day.
I wish you all the best in your recovery and as a very weak comfort, we are not alone!

Best Regards
Northerner


mrtkarabatur

Jun 5, 13 17:04

Post #14 of 22 (7113 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

Dear Sir,


thanks for your reply. I learned today that it is stage 1. I am really concerned abt avascular necrosis and do not understand the mechanics. When the bones die, they are dead right?! so do new bones produce or how the body reacts to recover itself? What should be done to make it better from outside?? What treatments?
The doctor only gave us resing with clutches again for 45-90 days...


Northerner

Jun 5, 13 21:06

Post #15 of 22 (7033 views)
Re: Bone Marrow Edema, is this it! [mrtkarabatur] [In reply to] Quote | Reply

I`m afraid I cant help you with the mechanics of avascular necrosis because I simply don`t know and I get worried only thinking about dead bones. I have read some reports about a medication called "iloprost"
so maybe you can ask your doctor and hear what she/he says!

http://www.bjj.boneandjoint.org.uk/.../83-B/6/855.full.pdf

http://www.ncbi.nlm.nih.gov/...articles/PMC2739485/


Regards
Northerner


mrtkarabatur

Jun 6, 13 4:27

Post #16 of 22 (6968 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

thanks again.


ggrigor

Nov 18, 13 11:29

Post #17 of 22 (5585 views)
Re: Bone Marrow Edema, is this it! [mrtkarabatur] [In reply to] Quote | Reply

Hello Northerner, I too have been diagnosed with bone marrow oedema of the medial femoral condyle, this has been since August 17. I am still struggling with recovery, taking similar vitamins and protein. I also have followed a no run, limited cycle and upper body strength work. I overexerted it on the weekend cycling, and now I feel as if I am back to square one.

I am due for a follow up MRI scan on Wednesday, and have booked in to have an expensive unloading knee brace fitted also. I was wondering how your knee is going, and if you are any closer to recovery? If so can you provide the course you have followed from your last post.

Thankyou .


dempsey

Dec 23, 13 11:59

Post #18 of 22 (5117 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

hello
I have just been DX with bone marrow edema. A long standing problem not picked up due to several cadaver knee replacements from sports injury. Extreme pain on weight bearing, sitting no problem.
I am 54 very active, any suggestions other than rest that you found effective?
t


Northerner

Dec 29, 13 16:42

Post #19 of 22 (4884 views)
Re: Bone Marrow Edema, is this it! [ggrigor] [In reply to] Quote | Reply

My knee is far from recovered and the course I follow is no speciality, but simply my normal training minus running, its upper body strength twice weekly, and two two strength exercises on lower body thrown in with the Swiss ball (squats hamstring curls). Swimming and bicycling have functioned for me. Swimming is best in open water, avoiding the wall kick, which following my physiotherapist is a no no.
I ride almost as previously but all the time aware of the injured knee. I have as said previously tried Ultrasound and Shockwave treatment but do to the location of the femoral condyle its difficult to get to it and also very little research available on this treatment and Bone marrow oedema. I have however found some relief and support in using Kinesiotape and will the coming spring check out if stem cell therapy can be an treatment option. http://www.regenexx.com/

Best of luck with your recovery.

Northerner.


dempsey

Jan 4, 14 22:05

Post #20 of 22 (4588 views)
Re: Bone Marrow Edema, is this it! [Northerner] [In reply to] Quote | Reply

I will be seeing my Ortho this week to also discuss PRP therapy! Plasma Rich Platelets from your own blood cells. Mainly given to patients with RA/OA, but clearly something to consider. I'm at the stage after 6wks with severe pain all weight bearing. For some reason seems like pain is more intense and progressive! I've been on crutches, swimming and doing upper body a few times a week! I love to know how folks work in this condition?


Active13

Jan 7, 14 12:45

Post #21 of 22 (4391 views)
Re: Bone Marrow Edema, is this it! [dempsey] [In reply to] Quote | Reply

Well am I pleased to have discovered this! Diagnosed with BME in November 2012. Just appeared one day. First appeared in my left foot and ankle and only truly disappeared in September 2013. It returned with a vengeance mid December 2013 in my right foot. My left foot is as good as new. Decided to take matters into my own hands as enough time had been spent talking about it, repeating MRI scans, and resting. Came across the following......http://www.bayerisches-osteoporose-zentrum.de/tl_files/OZ/pub_sonstiges/bme_bartl_2012.pdf and presented it to my Dr. Exploring treatment,. perhaps not with the same medication but one that is similar. Dr Bartl was helpful as I wrote to him and diccussed my diagnosis. I will keep you posted on the efficacy of treatment. As like many, my active and mobile self, mountain climbing has been non existent!


Northerner

Jan 9, 14 3:49

Post #22 of 22 (4249 views)
Re: Bone Marrow Edema, is this it! [Active13] [In reply to] Quote | Reply

Thanks for the link. I will for sure check out this myself.

Northerner.

   
 
 
 



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