Online first

Acta Reumatológica Portuguesa - Online First: 2021-08-28
Images in rheumatology

Bone marrow edema syndrome: an unusual cause for spontaneous unrelentless bilateral knee pain

Chambel A, Spranger A, Almeida P, Brito JSd

Abstract

Bone marrow edema syndrome is a rare disease with an unknown etiology, self-limited and usually associated with an indolent course, which can also generate severe pain with tremendous functional impairment. The authors present a case of a 19-year-old female patient with a progressive, non-traumatic and unrelentless pain involving both knees, requiring persistently walking aids and analgesic drugs. The imaging studies showed a bilateral distal femur and proximal tibia bone marrow edema in the magnetic resonance imaging. Finally, and after an extensive investigation without any abnormal findings, a bone marrow edema syndrome diagnosis was established, with a spontaneous regression of the clinical and imaging presentation. One year after the initial complaints the patient is fully recovered, without pain or medication, presenting an MRI showing complete regression of the initial findings. Despite the rarity of this entity, being aware of its existance and clinical manifestations is crutial to allow a proper diagnosis. The case herein presented is, to our understanding, pragmatic regarding bone marrow edema syndrome presentation and clinical course.