Knochenmarködeme und Osteonekrosen nach Meniskektomie

[Bone marrow edema syndrome from the perspective of appraisers and insurance clerks]

Various diseases or groups of diseases can trigger bone marrow edema (BME). The task of the appraiser is to work out the role of a diagnosed BME in the context of the causality based on liability; however, the inconsistent ICD 10 coding of the BME complex also poses a problem, especially for medically untrained insurance clerks. The coding of the BME as a fracture provided by the coding guidelines poses a problem when assessing reserves for damage settlement. Based on the etiology of BME an algorithm is presented that should make it easier for the expert as well as for the insurance clerk in the case of liability and also for the private accident insurance to classify the diagnosis of BME in the case.

[Bone marrow edema in magnetic resonance imaging. A misleading term?]

Magnetic resonance imaging (MRI) is a mainstay in musculoskeletal imaging. The term"bone marrow edema" is frequently used for describing the radiological findings, especially with respect to rheumatic diseases. The referring physician should be aware that this term has a purely descriptive character and the pathophysiology of signal alterations in MRI shows a broad spectrum certainly not always corresponding to increased liquid contents. The recommendations therefore tend towards the use of the neutral terms"osteitis","bone marrow edema-like lesion" or"bone marrow lesion" instead of the misleading term"bone marrow edema".