Posted in Avascular Necrosis, Bone Health, Bone Marrow, Bone Marrow Edema, Diagnosed, Osteonecrosis

Understanding Bone Marrow Edema-Linked To Osteonecrosis

Good Morning Pain Warriors Around The World

It is time to educate on the various causes of

Avascular Necrosis-Osteonecrosis

So twice a week we will post some educational info on a cause with links

Today Its Bone Marrow Edema

What is Bone Marrow Edema?

Bone marrow edema is a condition when excess fluids in the bone marrow build up and cause swelling. It is often caused by a response to an injury, such as a broken bone or a bruise, or a more chronic condition such as osteoporosis. Bone marrow edema most commonly occurs in the hips, knees and ankles. In this case, bone marrow edema of the knee is a main cause of localized knee and joint pain, and is only diagnosable via a Magnetic Resonance Imagining test (MRI).

It is usually caused by the following scenarios:

  • Avascular necrosis, or “bone death”. This is when a small portion of the bone dies, and can result in a painful bone marrow edema
  • Any type of knee bone trauma, including broken bones and bone bruises.
  • Joint disorders such as osteoarthritis or osteoporosis. In this case, the knee joint is lacking the cushion that cartilage provides, which can lead to easier fracture and wear on the bone. Subsequently, if a fracture of the bone occurs, the injured area becomes susceptible to edema..
  • Knee ligament injuries.
  • A condition such as synovitis (an inflammation of the lining the joints, called synovial membranes).
  • In rare conditions, bone tumor.

Symptoms of Bone Marrow Edema in the Knee

Bone marrow edemas may not bother you at all, or they may be painful and inconvenient. They can feel more intense than a muscular injury (for example, a muscle bruise) at times due to the nature of the bone. A muscle is capable of swelling, which increases blood flow to heal the area. Unfortunately, bones are not capable of swelling, and thus the fluid (edema) that collects in the marrow can create intense pressure within the bone, resulting in more intense pain. In fact, in many osteoarthritic patients, it isn’t the lack of cartilage that’s causing them pain, but rather the pressure due to the edema.

 

Some of the most common symptoms of bone marrow endema include:

  • Varying degrees of pain, from mild to moderate, depending on the severity and Trauma.
  • Swelling of the knee area.
  • Inability to put full pressure on the knee to walk.
  • Recurrent pain and tenderness.
  • Bruising.

Treatment of Bone Marrow Edema in the Knee

Thankfully, most bone marrow edemas will settle down and heal on their own after the injury has subsided. For example, in some cases of osteonecrosis the bone will regenerate itself and heal the edema but note : not all cases of osteonecrosis or spontaneous osteonecrosis of the knee will have the ability to heal itself. Unfortunately, though, in the case of osteoarthritis, the edema may only get worse over time. In this circumstance, treatment options may be explored.

Traditional treatments for bone marrow edema usually involve rehabilitation through physiotherapy and rest. Ice, medications such as ibuprofen or acetaminophen, and even a crutch or a cane can help as well. There is one drug-facilitated treatment that uses a bisphosphonate and vitamin D mixture to help increase bone density. When this treatment is delivered via intravenous, it is found to be quite effective in reducing pain and increasing density. Other drugs that usually treat the vascular system have been found effective for bone marrow edema, in that they encourage blood flow and treat any vascular abnormalities that may exist in the bone and marrow.

In some more challenging cases, core decompression may be used. This is a type of surgery where a surgeon drills a hole into the affected part of the bone allowing that area of the bone to experience increased blood flow, form new blood vessels, and heal.

Another option is subchondroplasty, which can be especially effective for osteoarthritis patients. In this procedure, an x-ray determines where the edema is. The patient is then sedated, and a small needle injects a paste into the area of the edema. The paste then hardens and provides more strength and density to the bone. By improving the strength of the bone, it will enable the bone to deal with the pain of the edema and of the osteoarthritis.

http://louisvillebones.com/understanding-bone-marrow-edema/

 

Knee

https://www.g2orthopedics.com/bone-marrow-edema-in-the-knee/

https://www.researchgate.net/…/7224238_Bone_marrow_edema_in…

https://www.researchgate.net/…/7224238_Bone_marrow_edema_in…

https://www.hindawi.com/journals/crirh/2018/7657982/

 

Hip Study

https://academic.oup.com/jcem/article/94/4/1068/2596208

 

https://www.ajronline.org/doi/10.2214/AJR.05.0086

 

https://www.ncbi.nlm.nih.gov/pubmed/15049532

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972799/

 

Shoulder

https://www.sciencedirect.com/…/veterinary-sc…/osteonecrosis

 

Ankle

https://www.ncbi.nlm.nih.gov/pubmed/21189186

https://www.footanklesurgery-journal.com/…/S1268-7…/abstract

https://wordpress.com/post/avascularnecrosiseducation.wordpress.com/128

 

If you have #Osteonecrosis feel free to join our #group

Avascular Necrosis / Osteonecrosis Support Int’l.

 

Priceless – King & Country  

king and country

 

This slideshow requires JavaScript.

 

 

 

Posted in Avascular Necrosis, Awareness, Bone Health, Bone Marrow, Diagnosed, The Human Body

What Is Bone Marrow & What Does It Actually Do?

Ever since I was diagnosed with several bone problems I have become fascinated by the human body and the bones are just a small portion of just how marvelous our body is.

Science is  constantly making new discoveries about the human body.

Fact: Did you know The Smallest Bone in the Human Body is in your ear- The Stirrup Bone located in your middle ear; it measures 2-3 millimeters.

Biggest (and Strongest) Bone in the Human Body: Femur – The femur is the strongest bone in the human body. It extends from the hip to the knee.  It can resist a force of up to 1,800 to 2,500 pounds. Only events of a large amount of force can cause it to break, such as by a car accident or a fall from an extreme height, taking months to heal.

Body Part with the Most Bones: The Hands – The hands have the most bones — 27 in each hand.The hands and feet together make up more than half the bones in the human body. There are 206 bones in the human body; 106 of these are in the hands and feet (27 in each hand and 26 in each foot).

Most Fragile Bone in the Body: The Toe Bones – The small toe bones break the easier and most often.

Most Commonly Broken Bone: The Ankle -Even more common than breaking a toes is spraining or breaking your ankle.

The Most Complex  parts of the body – The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia).

Now whats cool is learning about the marrow in the bones………

Bone marrow is a nutrient-rich spongy tissue located mainly in the hollow portions of long flat bones like the sternum and the bones of the hips. There are two types of bone marrow: red marrow and yellow marrow. Yellow marrow has a much higher amount of fat cells than red marrow. Both types of marrow contain blood vessels.
Stem Cells
The bone marrow works like a ‘factory’ that
produces all of the cells that are found
in the bone marrow and in the peripheral blood stream.

This factory is dependent on the function
of the pluripotent stem cells.

Pluripotent refers
to the ability of a cell to become many different
types of cells

Pluripotential is derived from the Latin

pluri meaning more and potential meaning power.

Fact :  Did You Know?
At birth, all bone marrow is red. As we age,
more and more of the marrow converts to
yellow bone marrow. In adults, about half of
the bone marrow is red and half is yellow.

marrow

The bone marrow has two types of stem cells, mesenchymal and hematopoietic. This
process of development of different blood cells from these pluripotent stem cells is
known as hematopoiesis.

Pluripotent hematopoietic cells say that 3 times real fast Pluripotent,Pluripotent,Pluripotent the Pluripotent hematopoietic cells can become any type of cell
in the blood system. Under the influence of tissue and hormonal factors these cells
develop into specific blood cell lines. When these cells differentiate or mature they
become the cells that we can recognize in the blood stream.

The majority of  our Red Blood Cell’s (RBCs),platelets, and most of the White Blood Cell’s (WBCs) are formed in the red marrow while only very  few of them are formed in the yellow marrow.

Everyone needs a continuous production cycle of blood cells from our bone marrow throughout our lives since each blood cell has a set life expectancy.

Healthy bone marrow produces as many cells as your body needs. Red
cell production is increased when the body needs additional oxygen, platelets increase when bleeding occurs, and white cells increase when infection threatens.

Fact: Did You Know?
Red blood cells live an average of
120 days and platelets live 8 – 10
days. Some white blood cells are
very short lived and live only hours,
while others can live for many years

As RBCs age, they become less active and become more fragile. The aging red cells are
removed or eaten up by white blood cells (macrophages) in a process known as phagocytosis and the contents of these cells are released into the blood. The iron from the hemoglobin of the destroyed cells is carried by the blood stream to either the bone marrow for production of new RBCs or to the liver or other tissues for storage.
Normally, a little less than 1% of the body’s total RBCs are replaced every day. The number of red blood cells produced each day, in the healthy person, is about 200 billion cells.

Importance of the Circulatory System
The circulatory system touches every organ and system
in your body. Red cells flow in the blood circulation
to transport oxygen. Every cell needs access to the
circulatory system in order to function since oxygen is
essential for proper cell function.

Hemoglobin
Hemoglobin (Hgb) is a protein that is found within
red blood cells. This protein is what makes ‘red cells’ red. Hemoglobin’s job is to pick up
oxygen in the lungs, carry it in the RBCs, and then release oxygen to the tissues that need
it like the heart, muscles, and brain. Hemoglobin also removes CO2
or carbon dioxide and
carries this waste product back to the lungs where it is exhaled.

Fact: Macrophage is derived from the Ancient Greek:
‘macro’ meaning big and ‘phage’ meaning eat.

Platelets
Platelets are produced in bone marrow by a process known as thrombopoiesis.
Platelets are critical to blood coagulation and the formation of clots to stop
bleeding.
Sudden blood loss triggers platelet activity at the site of an injury or wound.
Here the platelets clump together and combine with other substances to form fibrin.

Fibrin has a thread-like structure and forms an external scab or clot.

Platelet deficiency causes you to bruise and bleed more easily. Blood may not clot well at an open
wound, and there may be a greater risk for internal bleeding if the platelet count is very low.

Fact: Did You Know?
Healthy bone marrow normally manufactures
between 150,000 and 450,000 platelets per
microliter of blood, an amount of blood that fits
on the head of a pin

The majority of RBCs, platelets, and most of the WBCs are formed in the red marrow while only a few of them are formed in the yellow marrow. Everyone needs a continuous production cycle of blood cells from our bone marrow throughout our lives since each blood cell has a set life expectancy. Healthy bone marrow produces as many cells as your body needs.

Repeating Because This Is Important To Know : Red cell production is increased when the body needs additional oxygen, platelets increase when bleeding occurs, and white cells increase when infection threatens.

Iron
Iron is an important vital nutrient for  the body. It combines with protein to make the hemoglobin in red blood cells and is essential in the production of red blood cells (erythropoiesis). The body stores iron in the liver, spleen, and bone marrow. The storage form of iron is known as ferritin.
Ferritin can be measured through a blood test. Most of the iron needed each day for
making hemoglobin comes from the recycling of old red blood cells.

Red Blood Cells
The production of red blood cells is called
erythropoiesis. It takes about 7 days for a
committed stem cell to mature into a fully
functional red blood cell. Red blood cells
have a limited life span of approximately
120 days and must be continuously
replaced by the body.
Erythropoiesis is stimulated by a lack of oxygen (hypoxia) in the body. This lack of oxygen tells the kidneys to produce a hormone, erythropoietin (EPO). EPO then stimulates the bone marrow to produce RBCs.

Erythropoietin does this by entering the blood stream and traveling
throughout the body. All the body’s cells are exposed to erythropoietin, but only red bone
marrow cells respond to this hormone. As these new red cells are produced they move into the blood stream and increase the oxygen-carrying ability of the blood. When the tissues of the body sense that oxygen levels are enough, they tell the kidneys to slow the secretion of erythropoietin. This ‘feedback’ within your body ensures that the number of RBCs remains
fairly constant and that enough oxygen is always available to meet the needs of your body.
As RBCs age, they become less active and become more fragile. The aging red cells are
removed or eaten up by white blood cells (macrophages) in a process known as phagocytosis
and the contents of these cells are released into the blood. The iron from the hemoglobin of
the destroyed cells is carried by the blood stream to either the bone marrow for production of
new RBCs or to the liver or other tissues for storage.
Normally, a little less than 1% of the body’s total RBCs are replaced every day. The number of
red blood cells produced each day, in the healthy person, is about 200 billion cells.

White Blood Cells
The bone marrow produces many types of white blood cells, which are necessary for a healthy
immune system. These cells both prevent and fight infections. There are five main types of
white blood cells, or leukocytes:
Lymphocytes
Lymphocytes are produced in bone marrow. They make natural antibodies to fight
infection caused by viruses that enter your body through your nose, mouth, or cuts.
They do this by recognizing foreign substances that enter the body and then sending a
signal to other cells to attack those substances. The number of lymphocytes increases
in response to these invasions. There are two major types; B- and T-lymphocytes.
Monocytes
Monocytes are also produced in the bone marrow. Mature monocytes
have a life expectancy in the blood of only 3-8 hours, but when they
move into the tissues, they mature into larger cells called macrophages.
Macrophages can survive in the tissues for long periods of time where
they engulf and destroy bacteria, some fungi, dead cells, and other
material foreign to the body.
Granulocytes
Granulocyte is the family or collective name given to three types of white blood cells: neutrophils,
eosinophils and basophils. The development of a granulocyte may take two weeks, but this time
is shortened when there is an increased threat like a bacterial infection. The marrow also stores
a large reserve of mature granulocytes. For every granulocyte circulating within the blood, there
may be 50 to 100 cells waiting in the marrow to be released into the blood stream. As a result,
half the granulocytes in the blood stream can be available to actively fight an infection in your body within 7 hours of recognizing that an infection exists!

Once a granulocyte has left the blood it does not return. It may survive in the tissues for as long as 4 or 5 days depending
on the conditions it finds, but it only survives for a few hours in the circulation.
Neutrophils
Neutrophils are the most common granulocyte. They can attack and
destroy bacteria and viruses.
Eosinophils
Eosinophils are involved in the fight against many types of parasitic
infections and against the larvae of parasitic worms and other
organisms. They are also involved in some allergic reactions.
Basophils
Basophils are the least common of the white blood cells and respond to various allergens
that cause the release of histamines and other substances. These substances cause
irritation and inflammation in the affected tissues. Your body recognizes the irritation/
inflammation and widens (dilates) the blood vessels allowing fluid to leave the circulatory system and enter the tissue in an effort to dilute the irritant. This reaction is seen in hay fever, some forms of asthma, hives, and in its most serious form, anaphylactic shock.

So you see the body is such a marvelous complicated system we run it like its  a machine but its not a machine.

There is nothing  built today that runs as well as the human body and there is nothing more fascinating than the human body.

More Fun Facts:

If you use an average of 80 beats per minute, your heart beats about 4,800 times per hour. That’s a whopping 115,200 times per day. Over the course of a year, your heart would beat about 42,048,000 times! If you live to be at least 80 years old, your heart would have beaten approximately 3,363,840,000 times!

Your nose can remember 50,000 different scents.

An adult human being is made up of around 7,000,000,000,000,000,000,000,000,000 atoms.

• A human baby has over 60 more bones than an adult.

• There are 100,000 miles of blood vessels in an adult human body.

Pretty Cool 😎