Is Bone Marrow Edema syndrome (BMEs) associated with Osteoporosis? a single-center study

Background The term "bone marrow edema syndrome" (BMEs) refers to some primary clinical conditions characterized by a high signal on fluid-sensitive MRI sequences at the subchondral bone level, accompanied by pain. This study aimed to evaluate bone status and bone turnover in patients with BMEs compared to a control group. Materials and Methods A cohort of 150 patients with Complex Regional Pain Syndrome type 1(CRPS-I) (n = 56), hip BMEs (n = 37), and knee BMEs (n = 57) and 150 age- and sex-matched healthy controls were recruited for this study. In all we measured bone turnover markers, vitamin D and Bone Mineral Density (BMD) at lumbar spine and at femur by DXA. For a better estimate of bone tissue microarchitecture, we also calculated the Trabecular Bone Score (TBS). Results patients with BMEs exhibited significantly lower BMD at all skeletal sites and lower TBS values compared to healthy controls. The three groups of BMEs patients have significantly higher rates of osteoporosis compared to healthy controls and the rate of osteoporosis higher in patients with CRPS-I and hip BMEs than in those with knee BMEs. Vitamin D and markers of bone turnover show no significant differences among BEMs patients and controls. Conclusion This study indicates that patients with CRPS-I, as well as those with hip and knee BMEs, exhibit a significantly higher prevalence of osteoporosis and a notable reduction in TBS compared to age- and sex-matched healthy controls, thus confirming the pivotal role of bone tissue in the pathogenesis of these diseases.