Edema of the bone marrow in the spine
Swelling of the spinal cord or brain iscollective term. All processes that fall into this category are a particular pathology. It consists in the accumulation of excess fluid in the body - more precisely, in its cells and intercellular space. This leads to an increase in brain volume.
The medical literature practically does not usethis term. He does not have descriptions. Earlier, pathology was called "swelling and swelling of the brain," in which the main manifestations were squeezing and moving apart cells due to excess fluid. This led to disruption of oxygen transport and metabolism, and cells died. But the "clean" formulation of the concept of "edema" is not to be found today.
What is the edema of the bone marrow?
Edema of the bone marrow is the process of increasing liquids inbone tissue. It is incorrect to consider bone marrow edema as the cause of problems. This is simply a nonspecific manifestation, and it can be detected using an MRI. This formation appears due to any pathological process occurring in the hearth itself (traumatic damage of the bony beams is referred to as trabecular damage) or in sufficient proximity to edema. So, it appears as a consequence of damage to the cartilage of the joint with a violation of the subchondral plate.
Concerning the forecasts and recommendations, it should be noted that it is not the edema itself that is important here, but its causes. In addition, the functions of the joint and its other characteristics are important.
Bone marrow edema is a fluid congestionin the bone tissue. This is one of the nonspecific manifestations of any pathological process that goes on in the hearth. This phenomenon can be classified according to several features.
Among them is the prognosis of pathogenesis, according to which edema occurs:
Vazogennye, appearing because of the increasepermeability of capillaries, due to which the leakage of proteins and water begins in the so-called extracellular space with penetration through the walls of the vessels;
interstitial, appearing due to hydrocephalus;
cytotoxic edema of the bone marrow, whichrepresent a "swelling" of cells directly because of the accumulation of intracellular fluid. This, in turn, is a consequence of a decrease in metabolism, and the consequence of such pathologies is the disruption of the functioning of the cell membrane, accumulation in the cells of sodium, followed by water.
Edema can be of different types, but they have a standard clinical picture. So, the patient suffers from:
All these are manifestations that threaten life. You can mention the so-called preliminary syndromes - they include the manifestations of the syndrome of intracranial hypertension, which develops against the backdrop of an intensive increase in the volume of fluid in the cranial cavity. Given that the skull is a closed kind of space, the pressure of the liquid on the brain gets all the necessary conditions.
Symptoms of a bone marrow tumor are very serious. This is the most important organ that enters the hematopoietic system without which it is impossible to carry out the process of creating new blood cells. Recall that they automatically die. It can be seen in the spongy substance of the bones, and in addition, in the medullary cavity. The organ promotes immunopoiesis, i.e. for the maturation of cells of the immune system. and also - bone formation. If its condition is normal - it contains a huge number of cells of undifferentiated, low-grade and immature type, which are commonly compared to embryonic cells. They are unique, other bodies are not responsible for their lives.
It is easy to imagine how important health isof this body. So, for a certain focal symptomatology, the localization of edema in a separate part of the brain is clarified, because of the appearance of which there are malfunctions in the functioning of the affected area.
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Types of bone marrow edema:
Types of bone marrow edema can be distinguished by a number of signs. Recall that this will determine which measures will be chosen to eliminate this pathology and its consequences.
Trabecular edema of the bone marrow
Trabecular edema of the bone marrow is the firsta signal about a vertebral fracture. This is especially possible in case of a decrease in the height of the vertebral body with a fracture. If there is only edema - the presence of a vertebral contusion, the fracture is doubtful. The best way to demonstrate the situation here will be diagnostic methods such as X-ray or CT, and the MRI procedure will help as an additional method. This is because the pathology of soft tissue structures is diagnosed by MRI.
When trabecular edema should be observedan increase in the volume of fluid in the bone tissue, where speech is not only about traumatic genesis, but also about the inflammatory process. Treatment here will consist in taking potassium iodide, which has an anti-inflammatory effect. While the size of the protrusion is small, one should resort to treatment, regardless of its location. It is necessary to prevent protrusion of the spinal cord and the development of myelopathy, for which besides medicamental treatment and physiotherapy prescribe gloefleksoterapiyu and exercise therapy.
Edema of the bone marrow of the femur
Edema of the bone marrow of the femur cantake serious enough forms. Of great importance here is the reason for its appearance. So, if he accompanies the disease, osteomyelitis. manifestations are quite severe severity. This is a complex process with the formation of pus. It seizes bone and bone marrow, where bacteria of a harmful nature also spread, and requires complex treatment. In this case, edema is a consequence of the disease itself.
Also, this disease accompanies osteochondrosis. herniated intervertebral discs. They are established by means of MRI. The surgeon can determine the exact diagnosis.
Such edema may indicate a pathologybone protrusion in the femur. In this case, this bone is considered as a part of the knee, and in the disturbance of its functions it makes sense to worry - whether the patient has an edema of the bone marrow of this bone.
Subchondral edema of the bone marrow
Subchondral edema of the bone marrow mayturn into an irreparable injury for the whole body. Literally the term "subchondral" means "subchondral". As you know, bone consists of certain elements, among which are cartilage. This element is brittle and more elastic in the background of the skeleton.
Subchondral changes in bone marrow can beto determine using MRI and C - terminal cross-linked telopeptides of type II collagen (CTX-II). They are taken from the urine of the sick. Undoubtedly, analyzes are made and taking into account the composition of the blood, since the cartilage is directly related to the state of the bone marrow, involved in the blood formation.
The dynamics of bone marrow disorders sometimes occurs in just 3 months. The less this pathology - the less the rate of decay of cartilage.
Aseptic edema of the bone marrow
Aseptic edema of the bone marrow begins withsuch parts of the body as the head and neck of the femur. This is the so-called early (reversible) stage. It is identified long before the printout of X-ray symptoms.
If you watch MR-tomograms, you can seefollowing manifestations. It takes the form of areas of reduced intensity of the MR signal with respect to T1-VI and a higher one for T2-VI. This is clearly seen in comparison with the normal image of the fatty bone marrow. To fully explain the situation with this symptom, you need to use a sequence with suppression of adipose tissue.
Aseptic pathology can be distinguished byhyperemia, increased local temperature, swelling, pain, impaired function. It is accompanied by the development of a serous, serous-fibrinous, fibrinous variety of exudate. Inflammatory edema of this species can signal the development of aseptic inflammation.
Reactive bone marrow edema
The reactive edema of the bone marrow develops in the tissue in the form of a reaction, the cause of which is any intervention. To such it is possible to carry, for example, a postoperative field.
The reactive edema along with the pain syndrome often appears after the depression. Such patients undergo physiotherapy within 3-10 days.
To remove such edema, often recommend a coursecontrolled load. Rehabilitation is helped by a series of exercises - such as alternating positions. If there is a pronounced pain syndrome - it makes sense to prescribe analgesics. In particular, it helps with a similar edema that arose due to fracture of the hip bone in conditions of SCR.
Edema of the bone marrow of the tibia
Edema of the bone marrow of the tibia is rarely accompanied by revealed bone-destructive changes.
Bone marrow edema zones of this type are identifiedIn the areas of the medial condyles of the femoral and tibia. Their size depends on the reason for their appearance. So, at a sports loading they appear because of traumas and happen in the sizes 2, Ох 1,0 sm, etc. Their external symptoms are similar to osteosclerosis. In this case, in the joint gap pathologies are not always detected.
As we have already said, such a symptom as swellingbone marrow, often accompanies other diseases, especially in the absence of treatment. So, he accompanies the contusion of the areas of the bone marrow, synovitis. Such traumas appear under certain circumstances - for example, sharp bends of the trunk. Acute pain may not be, especially with surgical treatment and minor trauma. The leg is unbent and bends with varying degrees of difficulty.
Conjugation edema of the bone marrow
Contusional edema of the bone marrow is revealedstandard methods, such as MRI. Diagnosis is based on several steps, among them - personal consultation of the orthopedist, whose profile is the problems of the knee joint. It will be necessary to compare the data of the clinical examination and the results of MRI. Perhaps in the presence of symptoms:
It is necessary to consider, in what situations is actualformation of concussion edema of the bone marrow of the condyles of the femoral and tibia. Often they accompany the MR picture with a ruptured anterior cruciate ligament, and not only.
Recommendations for treatment are different. If the case is serious - recommend arthroscopic autoplasty of the anterior cruciate ligament and procedure for resection of the lateral meniscus. The heavier the injury, because of which this edema appeared, the more difficult the treatment. Often, the treatment of edema begins, for example, after the removal of gypsum. It should be remembered that if the bones after the fracture have merged incorrectly, then we will have to deal with several problems simultaneously.
Perifocal edema of the bone marrow
Perifocal edema of the bone marrow is formed inthe increase in extracellular space due to the accumulation of fluid in it. Her intake comes from damaged glial cells. The cell membrane has permeability, this refers to the membrane of the capillary endothelium in the zone around the lesion.
To determine the prevalence of the zonePerifocal edema is measured not only by the degree of increase in the water content in it. This formation is influenced by regional demyelination of white brain fibers.
Depending on the degree of demyelinationthe content of lipids in said perifocal zone is determined. This indicates the expression of disturbances in the processes of oxidation and phosphorylation with the formation of cerebral edema. This type of edema can form when a certain amount of plasma proteins enter the white matter of the brain and form their connection with glial elements. There is an increase in further fluid intake - it fills the perivasal space due to the osmotic gradient. A similar mechanism is characteristic for fluid intake from the cerebrospinal fluid system. Favorable environment for the development of tumors are lesions. Edema can occur around foci with different sizes, up to 1 cm. Depending on the complexity of the disease, surgical intervention is not always required.
Treatment of edema of the bone marrow
Treatment of the edema of the bone marrow is based on a number of important factors:
degree of manifestations of the pathological process;
character and degree of the role and influence of education on the functioning of the joint.
Elimination of the edema of the bone marrow is a rather difficult task. To solve it with great care, even highly qualified specialists. Self-medication is excluded.
Particularly the situation is complicated by the fact that anyAn incorrect action often leads to death. When there is a period of exacerbation - the doctor should take care of restoring the level of cerebral perfusion pressure. It is customary to call it the CPD. Then it will be possible to ensure normal blood circulation and the supply of the required substances to nerve cells. Normal maintenance for the edema of the bone marrow is an increase in intracranial pressure, followed by a sharp drop in the level of CPD.
To reduce the high level of pressure, they resort to help:
Elimination and prevention of pain syndrome.
Maintain body temperature within normal limits.
Prescribing diuretics to the patient to remove excess fluid.
Elimination of the causes that led to the violation of normal outflow of fluid.
Normalization of the volume of the spinal cord, which will help the course of drugs forced diuresis, necessary to regulate electrolyte metabolism.
You definitely need to monitorwater-electrolyte balance. When organizing the treatment of the edema of the bone marrow, it is very important to organize glucocorticoid therapy. Its task is the stabilization of cell membranes. This prevents the accumulation of catecholamines in damaged cells and tissues. Excellent showed themselves membrane protectors, which are also called "nootropics."
All these are components of conservative treatment. What it takes to bring the desired result? Perhaps, surgical treatment is required. With cerebral edema are struggling through trepanation of the skull, this will help lower the level of intracranial pressure. Through trepanation, the skulls are successful in decompression surgery. It consists in the removal of the bone flap by surgical methods.
Edema of the bone marrow is a serious problem. At its treatment it is necessary to cope with complex problems. The treatment should be chosen quickly. It is unacceptable to linger in the decision of this issue, it can cost the patient a life.
The author of the article: Zhuravlev Ivan Ivanovich, osteopathic doctor, chiropractor