Bone marrow edema pattern in osteoarthritic knees: correlation between MR imaging and histologic findings

Radiology. 2000 Jun;215(3):835-40. doi: 10.1148/radiology.215.3.r00jn05835.


Purpose: To correlate magnetic resonance (MR) images of a bone marrow edema pattern with histologic findings in osteoarthritic knees.

Materials and methods: Sixteen consecutive patients (age range, 43-79 years; mean, 67 years) referred for total knee replacement were examined with sagittal short inversion time inversion-recovery (STIR) and T1- and T2-weighted turbo spin-echo MR imaging 1-4 days before surgery. Tibial plateau abnormalities on MR images were compared quantitatively with those on histologic maps.

Results: The bone marrow edema pattern zone (ill-defined and hyperintense on STIR images and hypointense on T1-weighted MR images) mainly consisted of normal tissue (53% of the area was fatty marrow, 16% was intact trabeculae, and 2% was blood vessels) and a smaller proportion of several abnormalities (bone marrow necrosis [11% of area], abnormal [necrotic or remodeled] trabeculae [8%], bone marrow fibrosis [4%], bone marrow edema [4%], and bone marrow bleeding [2%]). The bone marrow edema pattern zone and the zone with a normal MR imaging appearance differed significantly in the presence of bone marrow necrosis (P =.021), bone marrow fibrosis (P =.014), and abnormal trabeculae (P =.011) but not in the prevalence of bone marrow edema (P =.069). Bone marrow edema also was found in zones with an unremarkable MR appearance (perifocal zone, 5% edema; control zone, 2% edema).

Conclusion: A bone marrow edema pattern in osteoarthritic knees represents a number of noncharacteristic histologic abnormalities. Edema is not a major constituent of MR imaging signal intensity abnormalities in such knees.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Bone Marrow / pathology
  • Bone Marrow Diseases / diagnosis*
  • Bone Marrow Diseases / pathology
  • Edema / diagnosis*
  • Edema / pathology
  • Female
  • Humans
  • Knee Joint / pathology
  • Magnetic Resonance Imaging* / instrumentation
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Observer Variation
  • Osteoarthritis, Knee / diagnosis*
  • Osteoarthritis, Knee / pathology
  • Time Factors