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Bone Contusion

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Introduction: Bone contusions, also named bone marrow like edema (BMEL) areas, are present in 80% of anterior cruciate ligament (ACL) tears. Its clinical and pathologic meaning is still uncertain. There seems to be an association between BMEL and anterior knee pain after ACL repair and cartilage damage in the knee after traumatic events. Nevertheless, there is scarce literature regarding presence and distribution of BMEL’s in other patterns of joint injury of the knee.
Objectives: Main purposes: 1) describe the pattern of localization of BMEL’s after knee sprain, regarding injured structures; 2) correlate the severity of BMEL’s with intra-articular injury types and associations.
Methods: Coorte study. Inclusion criteria: age>18 years, knee MRI 3Tesla with …show more content…

Results: 409 patients (207 male – M – and 202 females –F) were included. 91 (22%) presented BMEL in their MRI (54M/37F), averaging 30,2 +- 7,3 years old.
88% presented at least one articular injury –the most frequent were menisci 59% (IM 58%, EM 35%, IM+EM 23%) and ACL tear 54%.
BMEL distribution: ICF 42%, ECF 49%, ITP 41%, ETP 44%. BMEL frequency analysis revealed 1 area of contusion in 48% of patients, 2 in 33%, 3 in 13% and 4 in 6% of the patients.
Correlation of BMEL localization with the injured structure with statistical significance: IM-ETP in 46% (p=0,05), EM-ETP in 59%(p=0,029) and ITP in 56% (p=0,026), and Central Pivot-ETP in 69% (p=0,001).
Grouping of BMELs revealed internal areas of contusion more associated with IM injuries (p=0.023), and external areas with LCA tears (p=0,001).
Patients with IM+EM injuries (with or without central pivot lesion) had significantly increased number of BMELs (p=0,039). Injuries to more than 2 structures correlated with increased number of BMELs (p=0,01).

Men presented more contusions in the lateral compartment (78% Vs 57%, p=0,036) and 70% had associated menisci and ACL injuries (vs. 30% in women,

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