ArticleEuropean radiology2018
Bone marrow oedema predicts bone collapse in paediatric and adolescent leukaemia patients with corticosteroid-induced osteonecrosis.
Article in European radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 17 citations in OpenAlex.
- A New Stage and Classification of Osteonecrosis of the Femoral Head Based on MRI With Pathophysiological Interpretation.Orthopaedic surgery · 2026Article
- The pathomechanism of bone marrow edema in the femoral head necrosis with pericollapse stage.Scientific reports · 2025Article
- CT and MRI findings beyond the subchondral bone in osteonecrosis of the femoral head to distinguish between ARCO stages 2 and 3A.European radiology · 2023Article
- Efficacy and confounding factors of CT attenuation value differences in distinguishing acute and old vertebral compression fractures: a retrospective study.BMC musculoskeletal disorders · 2023Article
- Evolutionary course of the femoral head osteonecrosis: Histopathological - radiologic characteristics and clinical staging systems.Journal of orthopaedic translation · 2022Review
- Recent perspectives on the association between osteonecrosis and bone mineral density decline in childhood acute lymphoblastic leukemia.Faculty reviews · 2021Review
- How We Manage Bone Marrow Edema-An Interdisciplinary Approach.Journal of clinical medicine · 2020Article
- [Differential diagnoses of osteonecrosis of large joints].Der Orthopade · 2019Article
- [Differential diagnoses of osteonecrosis of large joints].Der Radiologe · 2019Article
- The skeletal impact of cancer therapies.British journal of clinical pharmacology · 2019Review
- Pericollapse Stage of Osteonecrosis of the Femoral Head: A Last Chance for Joint Preservation.Chinese medical journal · 2018Review
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesCorticosteroid treatment of paediatric leukaemia patients can lead to osteonecrosis (ON). We determined whether bone marrow oedema (BME) is an early sign of progressive ON and eventual bone collapse.
methodsIn a retrospective study, two radiologists reviewed MR imaging characteristics of 47 early stage epiphyseal ON in 15 paediatric and adolescent leukaemia patients. Associations between BME on initial imaging studies and subchondral fracture, disease progression and bone collapse were assessed by Cochran-Mantel-Haenszel tests. Differences in time to progression and bone collapse between lesions with and without oedema were assessed by log rank tests.
resultsForty-seven occurrences of ON were located in weight bearing joints, with 77% occurring in the femur. Seventeen lesions progressed to collapse, two lesions worsened without collapse, and 28 remained stable or improved. BME was significantly associated with subchondral fracture (p = 0.0014), disease progression (p = 0.0015), and bone collapse (p < 0.001), with a sensitivity and specificity of 94% and 77%, respectively, for bone collapse. Time to progression for ON with oedema was 2.7 years (95% CI: 1.7-3.4); while the majority of no-oedema ON were stable (p = 0.0011).
conclusionsBME is an early sign of progressive ON and eventual bone collapse in paediatric and adolescent leukaemia patients. KEY POINTS: • Bone marrow oedema in corticosteroid-induced osteonecrosis predicts progression to bone collapse. • Bone marrow oedema is associated with subchondral fractures in corticosteroid-induced osteonecrosis. • Bone marrow oedema can be used to stratify patients to joint-preserving interventions. • Absence of bone marrow oedema can justify a "wait and watch" approach.
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