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Subtendinous Bone Marrow Edema Patterns on MR Images of the Ankle

Association with Symptoms and Tendinopathy

William B. Morrison1, John A. Carrino1, Mark E. Schweitzer1, Timothy G. Sanders2, David P. Raiken2 and Charles E. Johnson2

1 Department of Radiology, Thomas Jefferson University Hospital, 111 S. 11th St., Philadelphia, PA 19107.
2 Department of Radiology, Wilford Hall Medical Center, San Antonio, TX 78236.



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  		Fig. 1A. —46-year-old woman with 12-month history of medial ankle pain and posterior tibialis tendinopathy associated with subtendinous bone marrow edema of medial malleolus. T2-weighted fat-suppressed fast spin-echo MR images of ankle in axial (A), sagittal (B), and coronal (C) planes show thickening of posterior tibialis tendon (long straight arrow) with increased internal signal (curved arrow). Note marrow edema in immediately subjacent medial malleolus (short straight arrow).

 


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  		Fig. 1B. —46-year-old woman with 12-month history of medial ankle pain and posterior tibialis tendinopathy associated with subtendinous bone marrow edema of medial malleolus. T2-weighted fat-suppressed fast spin-echo MR images of ankle in axial (A), sagittal (B), and coronal (C) planes show thickening of posterior tibialis tendon (long straight arrow) with increased internal signal (curved arrow). Note marrow edema in immediately subjacent medial malleolus (short straight arrow).

 


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  		Fig. 1C. —46-year-old woman with 12-month history of medial ankle pain and posterior tibialis tendinopathy associated with subtendinous bone marrow edema of medial malleolus. T2-weighted fat-suppressed fast spin-echo MR images of ankle in axial (A), sagittal (B), and coronal (C) planes show thickening of posterior tibialis tendon (long straight arrow) with increased internal signal (curved arrow). Note marrow edema in immediately subjacent medial malleolus (short straight arrow).

 


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  		Fig. 2A. —35-year-old man with 18-month history of lateral ankle pain and chronic peroneal tendinopathy associated with lateral calcaneal subtendinous bone marrow edema and bone proliferation. T2-weighted fat-suppressed fast spin-echo MR images in axial (A and B) and coronal (C) planes show peroneus longus tendon thickening and increased internal signal (thin arrow). Note underlying subtendinous bone marrow edema in calcaneus (thick arrow).

 


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  		Fig. 2B. —35-year-old man with 18-month history of lateral ankle pain and chronic peroneal tendinopathy associated with lateral calcaneal subtendinous bone marrow edema and bone proliferation. T2-weighted fat-suppressed fast spin-echo MR images in axial (A and B) and coronal (C) planes show peroneus longus tendon thickening and increased internal signal (thin arrow). Note underlying subtendinous bone marrow edema in calcaneus (thick arrow).

 


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  		Fig. 2C. —35-year-old man with 18-month history of lateral ankle pain and chronic peroneal tendinopathy associated with lateral calcaneal subtendinous bone marrow edema and bone proliferation. T2-weighted fat-suppressed fast spin-echo MR images in axial (A and B) and coronal (C) planes show peroneus longus tendon thickening and increased internal signal (thin arrow). Note underlying subtendinous bone marrow edema in calcaneus (thick arrow).

 


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  		Fig. 2D. —35-year-old man with 18-month history of lateral ankle pain and chronic peroneal tendinopathy associated with lateral calcaneal subtendinous bone marrow edema and bone proliferation. Axial proton density-weighted fast spin-echo MR image shows osseous excrescence (arrow) at site of marrow edema.

 

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