Effectiveness of extracorporeal shock wave therapy in bone marrow edema syndrome of the hip

There is no gold standard for treatment of bone marrow edema syndrome of the hip (BMESH). Usually, treatment is conservative, owing to the favorable and self-limiting prognosis. In musculoskeletal disorders, the effectiveness of extracorporeal shock wave therapy (ESWT) has been widely recognized and...

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Bibliographic Details
Published in:Rheumatology international 2014-11, Vol.34 (11), p.1513-1518
Main Authors: d’Agostino, Cristina, Romeo, Pietro, Lavanga, Vito, Pisani, Salvatore, Sansone, Valerio
Format: Article
Language:English
Subjects:
Adult
Arthralgia - diagnosis
Arthralgia - physiopathology
Arthralgia - therapy
Biomechanical Phenomena
Bone Marrow - pathology
Bone Marrow Diseases - diagnosis
Bone Marrow Diseases - physiopathology
Bone Marrow Diseases - therapy
Edema - diagnosis
Edema - physiopathology
Edema - therapy
Female
Follow-Up Studies
High-Energy Shock Waves - therapeutic use
Hip Joint - pathology
Hip Joint - physiopathology
Humans
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Pain Measurement
Prospective Studies
Radiotherapy, High-Energy - methods
Recovery of Function
Retrospective Studies
Rheumatology
Time Factors
Treatment Outcome
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Summary:There is no gold standard for treatment of bone marrow edema syndrome of the hip (BMESH). Usually, treatment is conservative, owing to the favorable and self-limiting prognosis. In musculoskeletal disorders, the effectiveness of extracorporeal shock wave therapy (ESWT) has been widely recognized and recent research supports its use in the treatment of the first stages of avascular osteonecrosis of the proximal femur and in other conditions where bone marrow edema is present. On this basis, we performed a prospective study to evaluate the effectiveness of ESWT in normalizing the symptoms and imaging features of BMESH. Twenty consecutive symptomatic patients underwent two treatments of high-energy ESWT and were followed-up at 2, 3 and 6 months, with a final clinical follow-up at mean 15.52 ± 1.91 months. Patients underwent magnetic resonance imaging of the hip and were evaluated according to the Harris hip score. The mean improvement in HHS over the course of the study was of 58.5 ± 14.9 points ( p  
ISSN:0172-8172
1437-160X
DOI:10.1007/s00296-014-2991-5