Transient bone marrow edema of the talus: MR imaging findings in five patients

Abstract

Objective: To describe the MR findings of transient bone marrow edema (TBME) of the talus and to address the differential diagnostic considerations. Design and patients: The imaging findings of TBME of six tali were retrospectively reviewed in five patients with a clinical history of pain without trauma. Inclusion criteria were MR imaging findings that, when compared with clinical data and results of follow-up assessment, allowed the diagnosis of TBME. MR imaging, standard radiography, and bone scintigraphy were performed. The images were reviewed with particular attention to the pattern and distribution of abnormal marrow signal intensity as well as associated findings. Results: In four cases the entire talus was involved, and in two cases only a portion of the bone was affected. No fractures were detected. MR imaging demonstrated diffuse decreased signal intensity of the marrow on T1-weighted images with corresponding increased signal intensity on T2-weighted images. In all six cases MR imaging detected associated findings, which included joint effusion and soft tissue edema. All patients improved clinically with conservative therapy over a period of 6 months to 1 year. Conclusions: Although unusual, TBME can involve the talus. Marrow edema without evidence of a fracture and in the absence of history of trauma is a characteristic MR imaging feature, allowing confident diagnosis and institution of conservative therapy.