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Osteologie 2017; 26(02): 96-99
DOI: 10.1055/s-0037-1622092
Knochenmarködemsyndrom
Schattauer GmbH

Bone bruise als Sonderfall des Knochenmarködems

Traumatic bone bruise
D. B. Hoffmann
1   Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie der Universitätsmedizin Göttingen, Göttingen
,
W. Lehmann
1   Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie der Universitätsmedizin Göttingen, Göttingen
,
S. Sehmisch
1   Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie der Universitätsmedizin Göttingen, Göttingen
› Author Affiliations
Further Information

Publication History

eingereicht: 28 March 2017

angenommen: 10 April 2017

Publication Date:
02 January 2018 (online)

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Zusammenfassung

Der traumatische bone bruise ist eine Sonderform des Knochenmarködems. Als Ursache werden trabekuläre Mikrofrakturen, Einblutungen, eine reaktive Hyperämie und Nekrosen bei intakter Kortikalis beschrieben. Der bone bruise wird auch als “footprint” des Verletzungs- bzw. Unfallmechanismus angesehen. Die Diagnostik erfolgt in der Regel durch MRT-Bildgebung. Bone bruise kann isoliert oder als Begleitverletzung auftreten und zeigt sich dann in verletzungstypischen Knochenarealen. Bone bruise ist häufig mit belastungsabhängigen Schmerzen assoziiert, jedoch sind auch asymptomatische Verläufe, besonders bei Sportlern, zu beobachten. Im Vordergrund der Therapie steht die Begleitverletzung. Bei isoliertem bone bruise erfolgt eine symptomatische Therapie mit Analgesie und Entlastung. Die Rückkehr zum vorherigen Aktivitätslevel beträgt durchschnittlich drei Monate. Veränderungen im MRT können auch über zwölf Monate hinaus anhalten. Eine Schädigung des über dem bone bruise befindlichen Gelenkknorpels gilt als sehr wahrscheinlich.

Summary

Bone bruise is part of the bone marrow edema and described as the footprint of the mechanism of injury. It is caused by trabecular microfractures, hyperemia, bleedings and necrosis without damage of cortical bone. In general bone bruise is detected by MRImaging. Bone bruise is often associated with additional joint and bone injuries, but it can be also detected as single injury. In general bone bruise causes pain, but especially athletes can be painless. Isolated bone bruise should be treated with protected weightbearing and analgesia. Return to functional sport activities needs in average 3 month. Bone bruise can still be present in MRI 12 month after injury. There is evidence for chondral defects in the corresponding articular cartilage after bone bruise.

Schlüsselwörter

Bone bruise - Knochenmarködem - Knorpelschaden

Keywords

Bone bruise - bone marrow edema - chondral defects
 

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