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Int J Sports Med 2023; 44(10): 683-691
DOI: 10.1055/a-2013-2226
Review

Asymptomatic Bone Marrow Edema in Weight-bearing Bones in Athletes and Military Trainees: A Systematic Literature Review

Amir Karimi
1   Medical School, Case Western Reserve University School of Medicine, Cleveland, United States
,
Mohamed El-Abtah
1   Medical School, Case Western Reserve University School of Medicine, Cleveland, United States
,
Margaret Sinkler
2   Department Of Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, United States
,
Navid Faraji
3   Department of Diagnostic Radiology, Division of Musculoskeletal Radiology, University Hospitals Cleveland Medical Center, Cleveland, United States
,
James Voos
2   Department Of Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, United States
4   University Hospitals Drusinsky Sports Medicine Institute, Cleveland, United States
,
Ethan Harlow
2   Department Of Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, United States
,
Shana Miskovsky
2   Department Of Orthopedic Surgery, University Hospitals Cleveland Medical Center, Cleveland, United States
4   University Hospitals Drusinsky Sports Medicine Institute, Cleveland, United States
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Abstract

Asymptomatic bone marrow edema (aBME) is a non-specific radiographic finding often found in athletes. Although aBME may represent the body's physiological response to training load, the etiology, MRI characteristics, and natural history of aBME remain unknown. To better characterize aBME in the lower extremities of military trainees and athletes. A systematic literature review in accordance with PRISMA guidelines was performed to identify primary research articles reporting on aBME in the lower extremities of athletes and military trainees. We identified 347 unique articles and after applying inclusion and exclusion criteria, 10 articles were included for qualitative synthesis. There were a total of 444 patients with an average age of 28.4±9.6 included. The most commonly used MRI sequences were proton-density with fat-saturation and T1-weighted imaging. The pattern of BME was inconsistently described, with various classification schemas used. The changes in aBME during longitudinal follow-up were dynamic and demonstrated both radiographic progression and regression. aBME is a highly prevalent and radiographically dynamic entity observed in high-level athletes and military trainees. Although follow-up was limited in the included studies, aBME may represent a natural, non-pathologic, reaction in response to specific biomechanical stressors.

Key words

bone marrow edema - athletes - military - military recruits - aBME - asymptomatic


Publication History

Received: 13 August 2022

Accepted: 03 January 2023

Article published online:
01 June 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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