• Peter R Kornaat and Samuel K Van de Velde.
• Samuel K. Van de Velde, Department of Orthopaedic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands. svandevelde@post.harvard.edu.
• Am J Sports Med. 2014 May 1;42(5):1242-6.

BackgroundThe clinical significance of an incidental finding of bone marrow edema (BME) on MRI in professional runners is poorly understood.PurposeTo investigate the prevalence and clinical and radiological progression of BME lesions in professional runners who consider themselves to be asymptomatic.Study DesignCase series; Level of evidence, 4.MethodsSixteen athletes (13 men and 3 women; mean age, 22.9 ± 2.7 years) were recruited from the Dutch National Committee middle-distance and long-distance running selection. All athletes had been injury free for the year before the study. Magnetic resonance imaging scans were obtained before the start of the season and at the end of the season. Both pubic bones, hips, knees, and ankles were scanned in a single session. Preseason and postseason Lysholm scores were obtained.ResultsFourteen of the 16 athletes had BME lesions before the start of the season (45 BME lesions in total). Most BME lesions (69%; 31/45) were located in the ankle joint and foot. More than half of the lesions (58%; 26/45) fluctuated during the season, with new lesions occurring (20%; 9/45) and old lesions disappearing (22%; 10/45). The few clinical complaints that occurred throughout the season were not related to the presence of BME lesions.ConclusionAlmost all asymptomatic athletes showed BME lesions, with more than half of the lesions fluctuating during the season. These data suggest that the incidental finding of a BME lesion on MRI of professional runners should not immediately be related to clinical complaints or lead to an altered training program.

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