The words “bone bruise” describe a condition also known as bone marrow edema or bonecontusion.
Many patients find these words confusing.
What does it mean to have a bone bruise?
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Bone Bruise
There is controversy about exactly what a bone bruise is.
Are they all the same, and why do they occur?
A bone bruise is thought to occur when there is a microscopic fracturing of the internal bone structure.
While these microfractures don’t significantly weaken the bone, they can cause bleeding and inflammation within the bone.
This can lead to pain and symptoms similar to a more familiar soft-tissue bruise.
The most appropriate way to refer to this finding on an MRI is “bone marrow edema.”
Traumatic Injury
Trauma is a common cause of bone marrow edema.
The trauma may be the result ofrepetitive overuse, or it may be the result of an acute injury.
Arthritis
Arthritiscauses damage to the cartilage surface of the joint.
This protective surface helps to shield and cushion the underlying bone.
Patients with arthritis often have evidence of bone bruising in the areas most affected by their condition.
Osteonecrosis
Osteonecrosis is a specific condition that causes interruption of the blood supply to the bone.
The lack of blood flow can lead to weakening of the bone.
These microfractures may cause bone marrow edema surrounding the area of osteonecrosis.
Treatment
Damaged bone needs rest and relief from stress.
When bone bruising is seen on an MRI, the bone is damaged and should be allowed to heal.
Most surgeons recommend limiting activity when bone bruising is found around a joint.
In these cases, there is often concern about damage to the cartilage of the joint.
Further damage to the bone supporting the cartilage can lead to a condition called post-traumatic arthritis.
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