Bone Marrow Edema

Written by Mary Jo DiLonardo
Medically Reviewed by Zilpah Sheikh, MD on April 06, 2025
4 min read

Bone marrow edema (BME) is when fluid builds up in your bone marrow. Your doctor may call it bone marrow lesions. The most common locations for it are your:

  • Hip
  • Knee
  • Ankle
  • Foot

Bone marrow is the soft, spongy tissue in the middle of most of your bones. It contains hematopoietic stem cells or blood stem cells, which can later become red blood cells, white blood cells, or platelets.

Bone marrow edema can be painful, but there are treatments for it. In some cases, it goes away on its own.

Bone marrow edema can happen for many reasons, including:

Injury 

A few different ones can lead to bone marrow edema. They include:

  • Stress or compression fractures
  • Bone bruises
  • Hip dislocations
  • Anterior cruciate ligament (ACL) tears
  • Plantar fasciitis (inflammation between the bottom of your foot and your heel)
  • Tendonitis (inflammation of a tendon)

Degenerative conditions

Both osteoarthritis and rheumatoid arthritis cause bone marrow edema. In the case of osteoarthritis, the edema usually happens alongside cartilage loss as the disease gets worse. Tendonitis, or any type of injury to your tendons that affects their function, can also lead to bone marrow edema.

Metabolic disorders

Several different metabolic disorders can cause bone marrow edema, including: 

  • Osteoporosis 
  • Cushing's syndrome
  • Hyperparathyroidism (your parathyroid glands produce too much parathyroid hormone)
  • Mastocytosis (your body makes too many mast cells)
  • Osteomalacia (a vitamin D deficiency that causes soft bones)

Cancer

Different types of cancer can also cause tumors and bone marrow edema. Some include:

  • Acute myeloid leukemia (AML)
  • Chondrosarcoma
  • Ewing's sarcoma
  • Osteosarcoma

Radiation treatments for bone cancers can also cause BME.

Bone infections 

When your body fights a bone infection (your doctor may call it osteomyelitis), your tissues tend to swell. That can bring extra fluid into your bones.

If you have bone marrow edema, you may or may not have symptoms.

Pain is usually the main sign that something is wrong. Some of the most common symptoms include:

  • Swelling just under your skin, especially in your legs or arms, or belly
  • When you press your skin, a dimple remains, also known as pitting
  • Feeling like your leg is heavy
  • Swollen, warm, and painful joints

Is bone marrow edema painful?

Yes. For some, the pain can be severe and may prevent them from doing their normal activities. The level of discomfort usually comes in three phases that last several months:

  1. The first month is when you will likely first have pain.
  2. The next one to two months are when the pain will be at its worst. 
  3. After your pain level peaks, it should begin to improve over several months.

Researchers think the pain may be caused by the irritation of neurovascular bundles in your bone marrow due to increased pressure from the fluid buildup.

If your doctor thinks you may have bone marrow edema, you'll get a physical and they'll ask you questions about your medical history. Also, you'll probably have blood tests to look for heavy inflammation in your body and a bone marrow biopsy to look for other signs of disease. 

Bone marrow edema doesn't show up on X-rays or CT scans. So if needed, your doctor will use an MRI or ultrasound for imaging. They may also perform a dual-energy X-ray absorptiometry (DXA) scan to test your bone density.

Can bone marrow edema be cancer? 

There's a chance bone marrow edema could be a symptom of cancer. But not all bone marrow edemas are caused by cancer. Some cases are caused by benign tumors and other medical conditions. So, if you have pain in your bones or joint swelling and inflammation, call your doctor right away for a diagnosis.

In many cases, bone marrow edema will go away with rest, physical therapy, and pain meds, such as nonsteroidal anti-inflammatory drugs (NSAIDs). You may have to rest for several months to feel better.

In more serious cases, your doctor may suggest other options, including steroid injections and even surgery. 

One procedure, core depression surgery, involves drilling tiny holes in the affected area to release pressure and ease your pain. Your surgeon may then fill the holes with stem cells or bone graft material to help healthy bone marrow grow.

Is bone marrow edema serious?

It is painful for sure, and while it usually goes away on its own, you need to find out the root cause. Sometimes, the condition causing bone marrow edema, such as cancer, serious injury, or undiagnosed arthritis, can be very serious.