Nononcological Bone Marrow Imaging

This issue of Seminars in Musculoskeletal Radiology focuses on bone marrow imaging in a wide range of non-oncological situations. Since the last issue of Seminars addressing this topic in 2011, many advances have been made, including:

• The emergence of new techniques to image the bone marrow, including spectral CT and fast spin echo chemical shift imaging and expanding indications for whole-body MRI.

• A better understanding of the strengths and weaknesses of existing imaging techniques, including diffusion-weighted imaging, dynamic contrast-enhanced-MRI, and ¹⁸Fluoro deoxy glucose PET-CT.

• The development of a common terminology. In particular, there has been great hesitation on how to refer to one of the main imaging signs of non-oncological bone marrow disorders, the so-called “bone marrow edema.” Recently, two consensus papers addressing the nomenclature of musculoskeletal disorders have proposed the term “bone marrow edema-like signal” to account for the non-specific nature of this sign in histological correlations.[1] [2] Consequently, we have asked the authors of the issue to use this consensual terminology in their manuscripts.

The first article of this issue reviews the strengths and limitations of advanced techniques for the imaging of bone marrow, with a focus on clinical practice. The following two articles present the normal aspects of bone marrow in the developing skeleton and in the adult. The latter particularly discusses the differentiation between focal marrow hyperplasia and bone-marrow-replacing lesions, a common challenge for radiologists.

Bone marrow is involved in a large range of conditions, notably various atraumatic lesions in the epiphyses, stress injuries in athletes, the diabetic foot, and inflammatory rheumatologic disorders. Each of these topics is covered by a dedicated paper.

Finally, the last two reviews of this issue address the many faces of bone marrow necrosis and the yet-to-discover marrow changes associated with accelerated bone remodeling.

It was for us a great pleasure to collaborate on coordinating this issue and we are grateful to the editors, Drs. Christine Chung and Christian Glaser, for granting us the opportunity to serve as guest editors. But most and foremost, we would like to thank all the authors for accepting our invitations and for providing great contributions!

Publication History

Article published online:
03 March 2023

• References

• 1 Gorbachova T, Amber I, Beckmann NM. et al. Nomenclature of Subchondral Nonneoplastic Bone Lesions. AJR Am J Roentgenol 2019; 213 (05) 963-982
• 2 Palmer W, Bancroft L, Bonar F. et al. Glossary of terms for musculoskeletal radiology. Skeletal Radiol 2020; 49 (Suppl. 01) 1-33