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

Bhatnagar, Archana; Rathore, Bhagyashree

ABSTRACT

Introduction:

Bone bruise or bone marrow edema is a common innocuous finding in magnetic resonance imaging (MRI) knee ofpatients with trauma. The pattern of bone marrow edema provides insight into the mechanism of injury which, in turn, helps to evaluatethe injuries with a more discerning eye. Five basic mechanisms of knee injury which are commonly seen in MRI scan of knee traumapatients are pivot shift, dashboard injury, hyperextension, clip injury, and lateral patellar dislocation. Each of these mechanisms causescharacteristic 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 andImaging, 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. Thepattern 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. Twotailed 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 andmedial meniscus tear, dashboard injury and posterior cruciate ligament (PCL) tear, lateral patellar dislocation and medial patellofemoralligament (MPFL) tear, and clip injury and medial collateral ligament (MCL) tear. Pivot shift was the most common bone marrowedema 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 finerevaluation and can help in creating better patient management outcomes.