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Author Topic: "Bone Oedema Syndrome" - Advice/Suggestions/Assistance greatly appreciated  (Read 14830 times)

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Offline magic_hat

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Hello All.

This morning i have been diagnosed with Bone Oedema Syndrome in my knee.  It has taken quite a while to get to this diagnosis and i am still a bit in the dark about quite a few things.  During the process, this website has been really helpful so i thought i'd turn to you guys yet again!

My Symptoms (Left Knee)
Regular pain going back a year or so.  Sometimes swells after excercise and occasionally collapses completely (when running or using stairs).  I seem to have reduced strength in my left knee and cannot rise from a squat using my left leg without significant difficulty. 

The diagnosis
My GP thought it was Patella Femoral Syndrome and referred me to NHS physiotherapist. 
She diagnosed Flat Feet (putting strain on my knees) and missing cruciates (either missing completely or ruptured).
I then saw a second physiotherapist who after doing the drawer and pivot shift tests confirmed the ruptured cruciate diagnosis added in a torn medial collateral ligament and referred me to an Orthopaedic Surgeon.
The Orthopaedic surgeon dismissed the ligament diganosis and said that he thought i had Patella Tendinitis (Tendinopathy) based on the areas i was experiencing pain and my symptoms.  He sent me for an MR Scan to confirm this.
I went back for my scan results and he told me that they confirm that all my ligaments are intact and that the scan clearly shows that i have Bone Oedema Syndrome in my knee.  He explained briefly what this is and that there isn't really any treatment for it except to stop doing things that cause me discomfort and that it should be gone in a few months.

My Questions
I came home and did an internet search about this condition but cannot find much actual information about what it is, what causes it and what symptoms it gives.  The info i can find seems to suggest that it is a condition that comes and goes and provides discomfort that will go on its own.  Does anyone have any more thorough info than this?

Also, is it possible that i have had this for a year without it going?  Can it be responsible for the knee collapses i have suffered? 

Some sites i have found refer to the condition as "bone bruising".  This makes it sound as if it is a fairly recent injury caused by a bad fall.... A couple of months ago, I had a bad fall whilst windurfing and hit my knee quite hard.  i am a bit concerned that this bruising may be a result of that and completely unrelated to my actual long standing knee problem.

As it stands i have a return appointment with the surgeon in 3 months to see if there has been improvement and possibly another MR scan but in the meantime i would be greatful for any advice that kneeguru -ites can offer.

thanks.


Offline magic_hat

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Re: "Bone Oedema Syndrome" - Advice/Suggestions/Assistance greatly appreciated
« Reply #1 on: December 10, 2006, 12:28:38 PM »
Anyone? Anything?

Offline kneeswontplease

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Re: "Bone Oedema Syndrome" - Advice/Suggestions/Assistance greatly appreciated
« Reply #2 on: December 27, 2006, 01:12:01 AM »
Hey--
I have been diagnosed with this and my doctor put me on crutches last week. It has been a nagging, slow healing situation.  He said it is brought on by impact, so definitely stay away from running.  How  are you doing since you last posted?  John

Offline cadenz2

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Re: "Bone Oedema Syndrome" - Advice/Suggestions/Assistance greatly appreciated
« Reply #3 on: December 27, 2006, 11:44:07 AM »
Hey
I was diagosed with the same thing.  My OS told me it takes 4 months for the swelling to settle - I'm now around 3 months since he picked it up with MRI.. but I don't think I'll be pain free in one more month.  I couldn't find much info on the net either.  Just stay away from actiivities that hurt your knee, and exercise to build up your strength.  I think this is a frustrating problem to deal with !  From my experience it is proving to be a very slow recovery....

Good luck, I know what you're going through!

Offline Thabo

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Re: "Bone Oedema Syndrome" - Advice/Suggestions/Assistance greatly appreciated
« Reply #4 on: February 09, 2007, 04:02:01 PM »
Hi Magic hat- how is your oedema proggressing?  - I have the same diagnosis and include my MRI result. I am in a lot of pain all the time in both knees and unable to squat with the R knee but have been told that my cartilage is ok. I am taking some meds and have been told that the recovery is going to be long and slow- up to 2 yrs!

Conclusion:
1. Early bilateral chondromalacia mainly affecting patellar interfacetal ridges but no major defects or fissures and the trochlear cartilage apears intact. No patello-femoral dysplasia.
2. Small foci of altered marrow signal in all three compartements in the R knee compatible with mild oedema-like signal possibly from disuse osteoporosis rather than transient osteoporosis.

Let me know if you have found out anything more.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline magic_hat

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Re: "Bone Oedema Syndrome" - Advice/Suggestions/Assistance greatly appreciated
« Reply #5 on: February 15, 2007, 10:42:28 AM »
Just checked this thread again and surprised to see some responses on here!  Thanks to everyone above who responded!

An update on my situation... 

After seeing the surgeon and getting the initial "bone oedema syndrome" diagnosis, I moderated the excerice I was doing and concentrated mainly on things that were none stressful on my knees (i.e. i cut running/jogging out totally).  I have moulded foot beds because of the flat feet diagnosis and was careful to wear them as often as possible.

In January I went skiing (wearing knee supports) and found that my knees held out pretty well.  I had some minor swelling and a bit of pain in the evenings, but overall there was a huge difference from last years ski trip when my knees were agony and had swollen to the size of a house.

Because of this improvement, I decided to pick up the level of excercise i was doing and one morning, feeling particularly confident about my knees, i went for a run.  What a disaster.  I had to give up after a couple of miles because my knees were giving me awful pain.  The next day, i seemed to be back to square one.  My knees were painful, jogging was painful, going up and down stairs was painful, rising from a squat was painful.  Both knees, exactly the same pain. 

I was due for my three month follow up with the surgeon and i had that earlier this week (this was three weeks after my disasterous attempted run and my knees have not improved at all).

I was able to pinpoint the exact area of pain and tenderness to him, which is the same spot on both knees.  He said that the area i was pointing at was the exact area on the scan where the oedema was and that the area of oedema was one of the largest he had seen around a knee.  He explained that he is 100% confident that his initial diagnosis is correct and that i have the oedema in both knees.  He also believe that the synovial fold (?) across my knee is inflamed which is also causing me problems and pains.  This could all be confirmed with an arthroscopy but that it would only confirm what he knows already so i opted not to have it done.

He believes that my oedema is being caused by some kind of slight problem with either my feet/knees or hips which is not detectable by simple physical examination.  This is causing pressure to be put on my knees wrongly and is flaring up the oedema.  This rings true because i had seen an improvement in my condition until i went running (without my moulded insoles).  My guess is that my flat feet are the problem and that the stress from running flat footed has caused the knee problem.

The surgeon basically told me that the only cure for this is management of the condition.  If the issue is being caused by something like my flat feet (or some other similar issue) the problem will always exist and the only way to stop the oedema from flaring is to avoid doing whatever activity caused the problem.

For me, that means wearing my insoles at all times and not doing any running or jogging.  Guess it's swimming and cycling for me from now on!





Offline Thabo

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Hi Magic hat

Could you please tell me which surgeon you were seeing. I have had bony oedema for at least 10 month now and I dont seem to be improving. I am not doing anything active and not walking more that 300 yards total a day. Very frustrating and I would just like another opinion.

Thanks.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline magic_hat

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Thabo

Will send you a PM with surgeon details.  I'm in the UK though, are you US based?

Offline magic_hat

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Couldn't find an option to send a PM or reply to your PM so searched the site "help pages".  It seems i can't send a PM until i have posted 21 times.  That seems a bit ridiculous... I don't want to post someones details on here but can't send you a PM....

This will be my 13th post... only 8 left before i can reply to your message.  What a bizarre rule. 

Sorry Thabo you might have to wait a while for my reply - or drop me a PM with your email address and I'll respond that way.

Offline Thabo

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Thanks.
Im in the UK.

Check your PM.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline fruitbat

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I have had this problem since February.  Still not better. Diagnosis was end of March. The advice was to minimise standing, walking. stairs etc.  After 6 weeks it seemed better.  The surgeon said that I needed to rest it for another 6 weeks.  I did this, but after 2 weeks it came back. I then had 2 weeks off work with crutches and another 2 weeks at work, using crutches and minimising activity, but I still have the problem.  The surgeon is unsure why and I am having an arthroscopy, although the MRI scan showed no other problem.

Offline kneeswontplease

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Fruitbat---

If your edema is on the medial tibial plateau, an unloader brace may give you some relief. kneeswp  best of luck