N.N. Priorov Journal of Traumatology and OrthopedicsN.N. Priorov Journal of Traumatology and OrthopedicsВестник травматологии и ортопедии им. Н.Н. Приорова0869-86782658-6738Eco-Vector63087010.17816/vto630870Clinical case reportsКлинические случаиResearch ArticleВone marrow edema in the differential diagnosis of deases of the kneeОтёк костного мозга в дифференциальной диагностике заболеваний коленного суставаhttps://orcid.org/0000-0002-2789-61728749-3890TorgashinAlexander N.ТоргашинАлександр Николаевич
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

alexander.torgashin@gmail.comhttps://orcid.org/0000-0002-9198-79174447-8306MorozovAlexander K.МорозовАлександр Константинович
Russian Federation

MD, Dr. Sci. (Medicine);

д-р мед. наук

morozovak@cito-priorov.ruhttps://orcid.org/0000-0001-8099-21078777-2790TorgashinaAnna V.ТоргашинаАнна Васильевна
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

anna.torgashina@gmail.comhttps://orcid.org/0009-0004-6068-3592MagomedgadgievRuslan M.МагомедгаджиевРуслан Магомедгаджиевич
Russian Federation

MD

arthro@list.ruhttps://orcid.org/0000-0002-5796-1238FedotovIvan A.ФедотовИван Андреевич
Russian Federation
fedotovmed@gmail.comhttps://orcid.org/0000-0002-2726-87583529-8052RodionovaSvetlana S.РодионоваСветлана Семёновна
Russian Federation

MD, Dr. Sci. (Medicine), professor

д-р мед. наук, профессор

rod06@inbox.ruPriorov National Medical Research Center of Traumatology and OrthopedicsНациональный медицинский исследовательский центр травматологии и ортопедии им. Н.Н. ПриороваNasonova Research Institute of RheumatologyНаучно-исследовательский институт ревматологии им. В.А. НасоновойTherapeutic and diagnostic center “Kutuzovsky”Лечебно-диагностический центр «Кутузовский»07112024251220243146476632404202424052024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://journals.eco-vector.com/0869-8678/article/view/630870

INTRODUCTION: Bone marrow edema (a radiological term used in MR diagnosis) is characterized by low-intensity infiltration on T1-weighted sequences and high-intensity signal on T2-weighted short-tau inversion recovery (T2w-STIR) images.

CLINICAL CASE DESCRIPTION: The paper presents a case series in patients with knee pain, with subchondral bone lesions on MRI, characterized by bone marrow edema with no previous injury. The following diagnoses were made based on the type of bone edema and medical history: aseptic necrosis of the condyle, subchondral fracture, osteochondritis, secondary osteonecrosis, osteoarthritis, septic arthritis, and others. The paper describes the approach to differential diagnosis based on MRI findings.

CONCLUSION: An assessment of bone marrow edema found on MRI in patients with knee pain allows for timely diagnosis clarification and treatment initiation in some cases.

Введение. Отёк костного мозга (радиологический термин, который используется при МР-диагностике) проявляется гипоинтенсивной инфильтрацией на Т1-взвешенных последовательностях и высокой интенсивностью сигнала в режиме T2 с подавлением жира (T2w-STIR).

Описание клинических случаев. В статье представлена серия клинических случаев пациентов с болью в коленном суставе, на МР-томограммах которых выявлено поражение субхондральной кости коленного сустава в виде отёка костного мозга, возникшего без предшествующей травмы. В зависимости от характера отёка костной ткани и анамнеза пациента были поставлены следующие диагнозы: асептический некроз мыщелка, субхондральный перелом, остеохондрит, вторичный остеонекроз, остеоартрит, септический артрит и некоторые другие. Показаны принципы проведения дифференциальной диагностики, основанные на особенностях МРТ-картины пациента.

Заключение. Оценка отёка костного мозга, выявленного на МРТ-исследовании при болевом синдроме в области коленного сустава, позволяет в ряде случаев своевременно уточнить диагноз и назначить лечение.

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