髋部骨髓水肿(BME)是一种放射学-临床疾病,症状范围从无症状到严重,它的特征是骨髓内的间质液增加,通常在股骨。根据病因,可以分为原发性或继发性。BME的主要病因未知,而次要形式包括创伤,退化,炎症,血管,传染性,新陈代谢,医源性,和肿瘤病因。BME可分为可逆性或进行性。可逆形式包括短暂性BME综合征和区域性迁徙性BME综合征。进展形式包括股骨头缺血性坏死(AVNH),软骨下功能不全骨折,和髋部退行性关节炎.诊断可能很困难,因为一开始,髋部疼痛的爆发,通常是急性和致残,没有任何先前的创伤或特殊的身体活动,射线照相结果支持不足。核磁共振是黄金标准,它在T1加权MRI扫描上显示一个中间信号区域,在T2加权扫描上显示一个高信号区域,通常缺乏锋利的边缘。在可逆形式中,BME通常是自我限制的,可以通过药物和物理治疗保守管理。非手术治疗失败的患者通常需要手术治疗,从股骨头和颈芯减压到全髋关节置换术。
Bone marrow edema (BME) of the hip is a radiological-clinical condition with symptoms ranging from asymptomatic to severe, and it is characterized by increased interstitial fluid within the bone marrow, usually at the femur. Depending on the etiology it can be classified as primary or secondary. The primary cause of BME is unknown, while the secondary forms include traumatic, degenerative, inflammatory, vascular, infectious, metabolic, iatrogenic, and neoplastic etiologies. BME could be classified as reversible or progressive. Reversible forms include transient BME syndrome and regional migratory BME syndrome. Progressive forms include avascular necrosis of the femoral head (AVNH), subchondral insufficiency fracture, and hip degenerative arthritis. The diagnosis can be difficult, because at the beginning, the outbreak of hip pain, typically acute and disabling without any prior trauma or exceptional physical activity, is poorly supported by radiographic findings. MRI is the gold standard, and it shows an area of intermediate signal on T1-weighted MRI scans and a high signal on T2-weighted scans, usually lacking sharps margins. In the reversible form, BME is typically self-limiting, and it can be managed conservatively by means of pharmacological and physical therapy. Surgery is generally required for progressive forms in patients who failed non-operative treatment, and it ranges from femoral head and neck core decompression to total hip arthroplasty.