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Differenzialdiagnosen des Knochenmarködems am Kniegelenk

Bone marrow edema of the knee joint

  • Kniegelenkdiagnostik
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Zusammenfassung

Das Knochenmarködem des Kniegelenks ist ein häufiges Erscheinungsbild in der MR-Diagnostik. Es kann mit Symptomen und Schmerzen des Gelenks einhergehen. Erkrankungen, die mit einem Knochenmarködem vergesellschaftet sind, können in verschiedene Gruppen eingeteilt werden.

Zur 1. Gruppe gehören das vaskulär-ischämische Knochenmarködem mit Osteonekrose (Synonyme SONK oder Morbus Ahlbäck), die Osteochondrosis dissecans und das Knochenmarködemsyndrom, zur 2. Gruppe das traumatologische oder mechanische Knochenmarködem. In der 3. Gruppe werden reaktive Knochenmarködeme zusammengefasst wie bei Gonarthrose, postoperative Knochenmarködeme und reaktive Ödeme bei Tumor oder tumorähnlichen Erkrankungen.

Der Nachweis eines Knochenmarködems gelingt mit der MRT sehr sensitiv, die rein morphologische MR-Information ist jedoch oft unspezifisch, sodass anamnestische und klinische Informationen für die sichere Zuordnung einer Erkrankung in den meisten Fällen notwendig sind.

Abstract

Bone marrow edema of the knee joint is a frequent clinical picture in MR diagnostics. It can be accompanied by symptoms and pain in the joint. Diseases that are associated with bone marrow edema can be classified into different groups.

Group 1 includes vascular ischemic bone marrow edema with osteonecrosis (synonyms: SONK or Ahlbäck’s disease), osteochondrosis dissecans, and bone marrow edema syndrome. Group 2 comprises traumatic or mechanical bone marrow edema. Group 3 encompasses reactive bone marrow edemas such as those occurring in gonarthrosis, postoperative bone marrow edemas, and reactive edemas in tumors or tumorlike diseases.

Evidence for bone marrow edema is effectively provided by MRI, but purely morphological MR information is often unspecific so that anamnestic and clinical details are necessary in most cases for definitive disease classification.

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Authors and Affiliations

  1. Institut für Radiologie, Waldviertelklinikum Horn/Österreich

    M. J. Breitenseher

  2. Abteilung Osteologie, Universitätsklinik für Radiodiagnostik Wien

    M. J. Breitenseher & M. E. Mayerhoefer

  3. Institut für CT- und MRT-Diagnostik am Schillerpark, Linz/Österreich

    J. Kramer

  4. Erste orthopädische Abteilung, Orthopädisches Krankenhaus Speising, Wien

    N. Aigner

  5. Orthopädische Abteilung, LKH Stolzalpe/Österreich

    S. Hofmann

  6. Institut für Radiologie, Waldviertelklinikum, Spitalgasse 10, A-3580 , Horn, Österreich

    M. J. Breitenseher

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  1. M. J. Breitenseher
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  2. J. Kramer
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  3. M. E. Mayerhoefer
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  4. N. Aigner
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  5. S. Hofmann
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Correspondence to M. J. Breitenseher.

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Breitenseher, M.J., Kramer, J., Mayerhoefer, M.E. et al. Differenzialdiagnosen des Knochenmarködems am Kniegelenk. Radiologe 46, 46–54 (2006). https://doi.org/10.1007/s00117-005-1304-0

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  • DOI: https://doi.org/10.1007/s00117-005-1304-0

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