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Knochenmarködem bei Gelenkverletzungen

Bone marrow edema and joint injuries

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Zusammenfassung

Hintergrund

Der Entwicklung von Knochenmarködemen in gelenknahen Körperabschnitten liegen viele Ursachen zugrunde, deren Differenzierung durch die MRT nicht möglich ist.

Definition

Knochenmarködeme stellen nicht zwangsläufig Mikrofrakturen dar. Die Definition der Knochenmarködeme ist eine rein radiologische Beschreibung. Einheitliche Klassifikationen der Knochenmarködeme gibt es nicht. Klinische Bedeutung, Therapie und Verlauf sind heterogen. Daher gibt es auch keine einheitlichen Therapieempfehlungen.

Diagnostik

Ein in der MRT sichtbares Knochenmarködem lässt nicht immer einen sicheren Rückschluss auf die Pathogenese zu. Um den Nachweis einer Fraktur erbringen zu können, sind eine Biopsie und eine histologische Untersuchung notwendig.

Schlussfolgerung

Die Interpretation der MRT-Befunde und die Herleitung einer Therapie bedürfen in jedem Einzelfall einer ausgewogenen Beurteilung von MRT, Anamnese, klinischer Untersuchung und klinischen Beschwerden.

Abstract

Background

The development of bone marrow edema in body regions adjacent to joints can have many causes and a differentiation is not possible using magnetic resonance imaging (MRI).

Definition

Bone marrow edema is not necessarily an indication for microfractures. The definition of bone marrow edema is a purely radiological description. There is no uniform classification of bone marrow edema. The clinical significance, therapy and course are heterogeneous; therefore, there are no uniform recommendations for therapy.

Diagnostics

A bone marrow edema visible in MRI does not always lead to certain inferences regarding the pathogenesis. In order to be able to detect fractures it is necessary to carry out a biopsy and a histological examination.

Conclusion

The interpretation of MRI results and the derivation of a therapy in every case need a balanced assessment of the MRI results, medical history, clinical investigations and clinical symptoms.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Rangger und S. Rogmans geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Orthopädie und Unfallchirurgie, Krankenhaus Nord West, Steinbacher Hohl 2–26, 60488, Frankfurt, Deutschland

    C. Rangger & S. Rogmans

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Correspondence to C. Rangger.

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Rangger, C., Rogmans, S. Knochenmarködem bei Gelenkverletzungen. Unfallchirurg 118, 206–212 (2015). https://doi.org/10.1007/s00113-014-2691-3

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