From bone marrow edema to osteonecrosis. New concepts
Del edema de médula ósea a la osteonecrosis. Nuevos conceptos
Guillermo Fernández-Cantón
Centro OSATEK, Unidad de Dr. Areilza, Bilbao, País Vasco, Spain
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New concepts" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "223" "paginaFinal" => "227" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Guillermo Fernández-Cantón" "autores" => array:1 [ 0 => array:3 [ "nombre" => "Guillermo" "apellidos" => "Fernández-Cantón" "email" => array:1 [ 0 => "gfernandez@osatek.es" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Centro OSATEK, Unidad de Dr. Areilza, Bilbao, País Vasco, Spain" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Del edema de médula ósea a la osteonecrosis. Nuevos conceptos" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-02-05" "fechaAceptado" => "2008-02-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec112197" "palabras" => array:3 [ 0 => "Bibliometrics" 1 => "Rheumatology" 2 => "Bibliometric analysis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec112198" "palabras" => array:6 [ 0 => "Osteonecrosis" 1 => "Necrosis avascular" 2 => "Síndrome del edema óseo transitorio de" 3 => "médula ósea" 4 => "Fracturas de insuficiencia" 5 => "Síndrome del dolor regional complejo tipo I" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The widespread use of MRI in the diagnosis of articular pathology has allowed for an improved knowledge of a series of disturbances that occur with epiphyseal bone edema as a main radiological sign, featured as low signal intensity of the bone marrow on T1 and high signal on STIR and fat saturated T2 sequences. The new etiopathogenic theories postulate a clear differentiation between primary and secondary osteonecrosis. While secondary osteonecrosis is related to risk factors, primary osteonecrosis is a result of a subcondral insufficiency fracture. Both have different characteristic and MRI criteria. The pathogenesis of transient bone edema syndrome (BMES) is currently under discussion, divided between the biomechanic theory and the more classic one that relates to the complex and poorly understood mechanisms associated with complex regional pain syndrome type I (reflex sympathetic dystrophy). The BMES, classically considered a reversible form of osteonecrosis, has enough differentiated features to be considered as a distinct disease. Bone marrow edema can be as extensive in either insufficiency or fatigue stress fractures than in BMES. The diagnostic key is the display of a subcondral bone fracture. These can be resolved or occasionally evolve into a primary osteonecrosis.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El uso generalizado de la resonancia magnética (RM) en el diagnóstico de la enfermedad articular ha permitido conocer mejor una serie de trastornos que cursan con edema óseo epifisario como signo radiológico principal, caracterizado por una hiposeñal de la médula ósea en secuencias T1 e hiperseñal en STIR o saturación grasa T2. Los nuevos conceptos etiopatogénicos acerca de la osteonecrosis postulan una clara diferenciación entre osteonecrosis primaria y secundaria. Mientras que la osteonecrosis secundaria se relaciona con factores de riesgo, la osteonecrosis primaria es consecuencia de una fractura subcondral de insuficiencia. Ambas tienen criterios de imagen en RM característicos y diferentes. La etiopatogénesis del síndrome del edema óseo transitorio (SEOT) se debate actualmente entre la teoría biomecánica y la teoría más clásica que la relaciona con mecanismos complejos y poco conocidos asociados al síndrome de dolor regional complejo tipo I (algodistrofia simpática refleja). El SEOT, clásicamente considerado una forma reversible de osteonecrosis, tiene características suficientemente diferenciales como para considerarse una enfermedad con entidad propia y de curso distinto a la osteonecrosis. En las fracturas de estrés, ya sean de insuficiencia o de sobrecarga, el edema puede ser tan extenso como en el SEOT y la clave diagnóstica es la visualización de fractura del hueso subcondral. Éstas pueden resolverse o evolucionar ocasionalmente hacia una osteonecrosis primaria.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Section credited by the SEAFRORMEC with 11.9 credits. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 23 | 18 | 41 |
| 2024 October | 118 | 97 | 215 |
| 2024 September | 97 | 74 | 171 |
| 2024 August | 119 | 86 | 205 |
| 2024 July | 125 | 66 | 191 |
| 2024 June | 122 | 87 | 209 |
| 2024 May | 138 | 95 | 233 |
| 2024 April | 97 | 53 | 150 |
| 2024 March | 69 | 61 | 130 |
| 2024 February | 45 | 45 | 90 |
| 2024 January | 67 | 58 | 125 |
| 2023 December | 78 | 57 | 135 |
| 2023 November | 68 | 59 | 127 |
| 2023 October | 98 | 86 | 184 |
| 2023 September | 86 | 93 | 179 |
| 2023 August | 52 | 37 | 89 |
| 2023 July | 41 | 72 | 113 |
| 2023 June | 64 | 52 | 116 |
| 2023 May | 48 | 64 | 112 |
| 2023 April | 50 | 59 | 109 |
| 2023 March | 62 | 78 | 140 |
| 2023 February | 52 | 69 | 121 |
| 2023 January | 54 | 67 | 121 |
| 2022 December | 59 | 49 | 108 |
| 2022 November | 66 | 56 | 122 |
| 2022 October | 74 | 57 | 131 |
| 2022 September | 122 | 97 | 219 |
| 2022 August | 92 | 76 | 168 |
| 2022 July | 60 | 68 | 128 |
| 2022 June | 65 | 55 | 120 |
| 2022 May | 88 | 83 | 171 |
| 2022 April | 100 | 100 | 200 |
| 2022 March | 76 | 92 | 168 |
| 2022 February | 70 | 75 | 145 |
| 2022 January | 76 | 81 | 157 |
| 2021 December | 37 | 105 | 142 |
| 2021 November | 57 | 87 | 144 |
| 2021 October | 99 | 104 | 203 |
| 2021 September | 40 | 82 | 122 |
| 2021 August | 42 | 104 | 146 |
| 2021 July | 48 | 75 | 123 |
| 2021 June | 57 | 107 | 164 |
| 2021 May | 81 | 87 | 168 |
| 2021 April | 122 | 170 | 292 |
| 2021 March | 80 | 98 | 178 |
| 2021 February | 57 | 51 | 108 |
| 2021 January | 57 | 38 | 95 |
| 2020 December | 50 | 40 | 90 |
| 2020 November | 46 | 43 | 89 |
| 2020 October | 60 | 27 | 87 |
| 2020 September | 44 | 38 | 82 |
| 2020 August | 50 | 19 | 69 |
| 2020 July | 50 | 23 | 73 |
| 2020 June | 45 | 29 | 74 |
| 2020 May | 53 | 23 | 76 |
| 2020 April | 41 | 22 | 63 |
| 2020 March | 15 | 12 | 27 |
| 2020 February | 2 | 0 | 2 |
| 2019 January | 3 | 0 | 3 |
| 2018 December | 2 | 0 | 2 |
| 2018 May | 3 | 1 | 4 |
| 2018 April | 39 | 8 | 47 |
| 2018 March | 58 | 10 | 68 |
| 2018 February | 33 | 4 | 37 |
| 2018 January | 32 | 5 | 37 |
| 2017 December | 33 | 14 | 47 |
| 2017 November | 26 | 17 | 43 |
| 2017 October | 36 | 23 | 59 |
| 2017 September | 60 | 21 | 81 |
| 2017 August | 47 | 17 | 64 |
| 2017 July | 42 | 18 | 60 |
| 2017 June | 42 | 37 | 79 |
| 2017 May | 45 | 30 | 75 |
| 2017 April | 34 | 43 | 77 |
| 2017 March | 24 | 43 | 67 |
| 2017 February | 21 | 30 | 51 |
| 2017 January | 29 | 5 | 34 |
| 2016 December | 38 | 24 | 62 |
| 2016 November | 37 | 23 | 60 |
| 2016 October | 40 | 33 | 73 |
| 2016 September | 34 | 30 | 64 |
| 2016 August | 57 | 22 | 79 |
| 2016 July | 23 | 30 | 53 |
| 2016 June | 0 | 21 | 21 |
| 2016 May | 2 | 25 | 27 |
| 2016 April | 0 | 24 | 24 |
| 2016 March | 0 | 18 | 18 |
| 2016 February | 4 | 34 | 38 |
| 2016 January | 2 | 19 | 21 |
| 2015 December | 2 | 0 | 2 |
| 2015 November | 1 | 0 | 1 |
| 2015 October | 3 | 0 | 3 |
| 2015 September | 1 | 0 | 1 |
| 2015 July | 17 | 4 | 21 |
| 2015 June | 25 | 114 | 139 |
| 2015 May | 47 | 164 | 211 |
| 2015 April | 39 | 176 | 215 |
| 2015 March | 32 | 183 | 215 |
| 2015 February | 19 | 174 | 193 |
| 2015 January | 35 | 182 | 217 |
| 2014 December | 21 | 143 | 164 |
| 2014 November | 33 | 190 | 223 |
| 2014 October | 26 | 235 | 261 |
| 2014 September | 31 | 188 | 219 |
| 2014 August | 29 | 194 | 223 |
| 2014 July | 30 | 220 | 250 |
| 2014 June | 40 | 182 | 222 |
| 2014 May | 37 | 161 | 198 |
| 2014 April | 46 | 125 | 171 |
| 2014 March | 42 | 98 | 140 |
| 2014 February | 35 | 109 | 144 |
| 2014 January | 41 | 83 | 124 |
| 2013 December | 31 | 67 | 98 |
| 2013 November | 29 | 68 | 97 |
| 2013 October | 40 | 81 | 121 |
| 2013 September | 33 | 89 | 122 |
| 2013 August | 29 | 71 | 100 |
| 2013 July | 26 | 57 | 83 |
| 2013 June | 23 | 56 | 79 |
| 2013 May | 22 | 51 | 73 |
| 2013 April | 14 | 39 | 53 |
| 2013 March | 29 | 37 | 66 |
| 2013 February | 27 | 25 | 52 |
| 2013 January | 17 | 20 | 37 |
| 2012 December | 22 | 18 | 40 |
| 2012 November | 6 | 14 | 20 |
| 2012 October | 4 | 5 | 9 |
| 2012 September | 9 | 3 | 12 |
| 2012 June | 1 | 0 | 1 |
| 2012 May | 1 | 0 | 1 |
| 2012 April | 5 | 0 | 5 |
| 2012 March | 8 | 0 | 8 |
| 2012 February | 3 | 0 | 3 |
| 2012 January | 3 | 0 | 3 |
| 2011 December | 6 | 0 | 6 |
| 2011 November | 7 | 0 | 7 |
| 2011 October | 2 | 0 | 2 |
| 2011 September | 1 | 0 | 1 |
| 2011 August | 1 | 0 | 1 |
| 2011 July | 4 | 0 | 4 |
| 2011 June | 7 | 0 | 7 |
| 2011 May | 2 | 0 | 2 |
| 2011 April | 4 | 0 | 4 |
| 2011 March | 4 | 0 | 4 |
| 2011 February | 5 | 0 | 5 |
| 2011 January | 4 | 0 | 4 |
| 2010 December | 4 | 0 | 4 |
| 2010 November | 6 | 0 | 6 |
| 2010 October | 5 | 0 | 5 |
| 2010 September | 9 | 0 | 9 |
| 2010 August | 2 | 0 | 2 |
| 2010 July | 2 | 0 | 2 |
| 2010 June | 5 | 0 | 5 |
| 2010 April | 3 | 0 | 3 |
| 2010 March | 25 | 0 | 25 |
| 2010 February | 13 | 0 | 13 |
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