Table of ContentsView AllTable of ContentsCausesComplicationsWhen to See a Provider

Table of ContentsView All

View All

Table of Contents

Causes

Complications

When to See a Provider

Bone marrow edemaoccurs when fluid builds up inside yourbone marrow(the spongy mass in the center of bones that produces blood cells). There are many possible causes of bone marrow edema, ranging from arthritis and bone injury to more serious or debilitating conditions like osteoporosis, bone infections, bone tumors, and bone cancer.

This article describes common causes of bone marrow edema. It also explains when it is time to see a healthcare provider as well as the possible signs and symptoms of bone cancer

Siri Stafford / Getty Images

Doctor and nurse look at x-ray - stock photo

Bone Marrow Edema Causes

As with all forms ofedema, bone marrow edema involves the swelling of tissues due to the build-up of fluids. There are many possible causes for this.

Arthritis

Both inflammatory and non-inflammatory arthritis can cause bone marrow edema. With non-inflammatory arthritis, the degeneration of bone can cause changes that place direct pressure on the underlying marrow.

Types of arthritis that can cause bone marrow edema include:

Injury

Injuries like this causeinflammation, a normal protective response that causes the widening of blood vessels and swelling of surrounding tissues.

Injuries that can cause bone marrow edema include:

Osteoporosis

Bone marrow edema can occur with severe osteoporosis, particularly in the knees and hips. It tends to come and go rather than being persistent.

Bone Infection

Osteomyelitisis an infection of the bone. It is relatively uncommon but can cause damage to the blood vessels servicing the bone. If the blood supply is significantly reduced, bone tissues can start to die (referred to asosteonecrosis).

Bone marrow edema is characteristic of osteomyelitis, especially in the hip.

Bone Tumors

There are many different types of benign bone tumors, including:

Cancer

Cancers associated with bone marrow edema not only include those that start in the bone but also those that spread (metastasize) from a cancerous tumor in other parts of the body to the bone or bone marrow.

These include:

Almost all cancers can spread to the bone, but the cancers that most often do include breast cancer, lung cancer, prostate cancer, kidney cancer, melanoma, ovarian cancer, and thyroid cancer.

In most cases, bone marrow edema is secondary to another condition such as cancer, osteomyelitis, arthritis, or an injury. The most common complication is severe and sometimes debilitating pain. Although the symptoms will typically resolve on their own (or when the underlying condition is treated), the pain can take a serious toll on a person’s well-being until it does.

Less commonly, bone marrow edema can occur on its own for no known reason, a condition referred to as bone marrow edema syndrome (BMES). BMES is a self-limited condition that mostly affects middle-aged males and younger females who experience sudden or gradual pain and swelling in the lower extremities (mainly the hip, knee, ankle, or foot).

The pain may be present while resting but tends to get worse with activity or at night. The symptoms may be unilateral (occurring on one side of the body) or bilateral (affecting the same body part on both sides of the body).

BMES is diagnosed when edema is spotted on amagnetic resonance imaging (MRI) scanand no other explanation is found. An MRI is preferred because it is better at imaging soft tissues than X-rays orcomputed tomography (CT) scans.

When to See a Healthcare Provider

If you experience sudden or persistent bone pain in the absence of a known cause, it is in your interest to see a healthcare provider. This is especially true if the pain is severe and interfering with your mobility. Other symptoms to watch out for are warm and swollen joints (joint effusion).

If you have bone cancer, you are likely to experience a cascade of symptoms that warrant an immediate visit with your healthcare provider.

Bone cancer may require chemotherapy, radiation, immunotherapy, and surgery.

Summary

Bone marrow edema is a buildup of fluid inside your bones. It can happen because of an injury such as a fracture. Or, it may be related to a health condition like osteoarthritis, a bone infection, a bone tumor, or cancer. Less commonly, it can occur on its own for no known reason, a condition referred to as bone marrow edema syndrome (BMES).

9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Molfetta L, Florian A, Saviola G, Frediani B.Bone marrow edema: pathogenetic features.Clin Ter. 2022 Sep-Oct;173(5):434-9. doi:10.7417/CT.2022.2459Tarantino U, Greggi C, Cariati I, et al.Reviewing bone marrow edema in athletes: a difficult diagnostic and clinical approach.Medicina (Kaunas).2021 Nov;57(11):1143. doi:10.3390/medicina57111143Maisi N, Patoulias D, Tsagkaris C, Tsagatakis M, Goules D.Transient hip osteoporosis: etiopathogenetic, clinical, and imaging approach.Mediterr J Rheumatol.2022 Jun;33(2):196–200. doi:10.31138/mjr.33.2.196National Organization for Rare Disorders (NORD).Osteomyelitis.Gao S, Zhou R, Xu Q, Chen H.Edema surrounding benign tumors and tumor-like lesions.Biomed Res Int.2019;2019:8206913. doi:10.1155/2019/8206913Baumbach SF, Pfahler V, Pozza SBD, et al.How we manage bone marrow edema—an interdisciplinary approach.J Clin Med.2020 Feb;9(2):551. doi:10.3390/jcm9020551Macedo F, Ladeira K, Pinho F, et al.Bone metastases: an overview.Oncol Rev. 2017 May 9;11(1):321. doi:10.4081/oncol.2017.321Manara M, Varenna M.A clinical overview of bone marrow edema,Reumatismo.2014 Jul 28;66(2):184-96. doi:10.4081/reumatismo.2014.790Chambel A, Spranger A, Almeida P, do Briot JS.Bone marrow edema syndrome: an unusual cause for spontaneous unrelentless bilateral knee pain.Acta Reumatol Port.2021 Oct-Dec;46(4):360-2.

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Molfetta L, Florian A, Saviola G, Frediani B.Bone marrow edema: pathogenetic features.Clin Ter. 2022 Sep-Oct;173(5):434-9. doi:10.7417/CT.2022.2459Tarantino U, Greggi C, Cariati I, et al.Reviewing bone marrow edema in athletes: a difficult diagnostic and clinical approach.Medicina (Kaunas).2021 Nov;57(11):1143. doi:10.3390/medicina57111143Maisi N, Patoulias D, Tsagkaris C, Tsagatakis M, Goules D.Transient hip osteoporosis: etiopathogenetic, clinical, and imaging approach.Mediterr J Rheumatol.2022 Jun;33(2):196–200. doi:10.31138/mjr.33.2.196National Organization for Rare Disorders (NORD).Osteomyelitis.Gao S, Zhou R, Xu Q, Chen H.Edema surrounding benign tumors and tumor-like lesions.Biomed Res Int.2019;2019:8206913. doi:10.1155/2019/8206913Baumbach SF, Pfahler V, Pozza SBD, et al.How we manage bone marrow edema—an interdisciplinary approach.J Clin Med.2020 Feb;9(2):551. doi:10.3390/jcm9020551Macedo F, Ladeira K, Pinho F, et al.Bone metastases: an overview.Oncol Rev. 2017 May 9;11(1):321. doi:10.4081/oncol.2017.321Manara M, Varenna M.A clinical overview of bone marrow edema,Reumatismo.2014 Jul 28;66(2):184-96. doi:10.4081/reumatismo.2014.790Chambel A, Spranger A, Almeida P, do Briot JS.Bone marrow edema syndrome: an unusual cause for spontaneous unrelentless bilateral knee pain.Acta Reumatol Port.2021 Oct-Dec;46(4):360-2.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Molfetta L, Florian A, Saviola G, Frediani B.Bone marrow edema: pathogenetic features.Clin Ter. 2022 Sep-Oct;173(5):434-9. doi:10.7417/CT.2022.2459Tarantino U, Greggi C, Cariati I, et al.Reviewing bone marrow edema in athletes: a difficult diagnostic and clinical approach.Medicina (Kaunas).2021 Nov;57(11):1143. doi:10.3390/medicina57111143Maisi N, Patoulias D, Tsagkaris C, Tsagatakis M, Goules D.Transient hip osteoporosis: etiopathogenetic, clinical, and imaging approach.Mediterr J Rheumatol.2022 Jun;33(2):196–200. doi:10.31138/mjr.33.2.196National Organization for Rare Disorders (NORD).Osteomyelitis.Gao S, Zhou R, Xu Q, Chen H.Edema surrounding benign tumors and tumor-like lesions.Biomed Res Int.2019;2019:8206913. doi:10.1155/2019/8206913Baumbach SF, Pfahler V, Pozza SBD, et al.How we manage bone marrow edema—an interdisciplinary approach.J Clin Med.2020 Feb;9(2):551. doi:10.3390/jcm9020551Macedo F, Ladeira K, Pinho F, et al.Bone metastases: an overview.Oncol Rev. 2017 May 9;11(1):321. doi:10.4081/oncol.2017.321Manara M, Varenna M.A clinical overview of bone marrow edema,Reumatismo.2014 Jul 28;66(2):184-96. doi:10.4081/reumatismo.2014.790Chambel A, Spranger A, Almeida P, do Briot JS.Bone marrow edema syndrome: an unusual cause for spontaneous unrelentless bilateral knee pain.Acta Reumatol Port.2021 Oct-Dec;46(4):360-2.

Molfetta L, Florian A, Saviola G, Frediani B.Bone marrow edema: pathogenetic features.Clin Ter. 2022 Sep-Oct;173(5):434-9. doi:10.7417/CT.2022.2459

Tarantino U, Greggi C, Cariati I, et al.Reviewing bone marrow edema in athletes: a difficult diagnostic and clinical approach.Medicina (Kaunas).2021 Nov;57(11):1143. doi:10.3390/medicina57111143

Maisi N, Patoulias D, Tsagkaris C, Tsagatakis M, Goules D.Transient hip osteoporosis: etiopathogenetic, clinical, and imaging approach.Mediterr J Rheumatol.2022 Jun;33(2):196–200. doi:10.31138/mjr.33.2.196

National Organization for Rare Disorders (NORD).Osteomyelitis.

Gao S, Zhou R, Xu Q, Chen H.Edema surrounding benign tumors and tumor-like lesions.Biomed Res Int.2019;2019:8206913. doi:10.1155/2019/8206913

Baumbach SF, Pfahler V, Pozza SBD, et al.How we manage bone marrow edema—an interdisciplinary approach.J Clin Med.2020 Feb;9(2):551. doi:10.3390/jcm9020551

Macedo F, Ladeira K, Pinho F, et al.Bone metastases: an overview.Oncol Rev. 2017 May 9;11(1):321. doi:10.4081/oncol.2017.321

Manara M, Varenna M.A clinical overview of bone marrow edema,Reumatismo.2014 Jul 28;66(2):184-96. doi:10.4081/reumatismo.2014.790

Chambel A, Spranger A, Almeida P, do Briot JS.Bone marrow edema syndrome: an unusual cause for spontaneous unrelentless bilateral knee pain.Acta Reumatol Port.2021 Oct-Dec;46(4):360-2.

Meet Our Medical Expert Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?OtherHelpfulReport an ErrorSubmit

What is your feedback?