Radiological and sympthomatic early results of intravenous iloprost treatment in patients with bone marrow edema in the lower extremity

ABSTRACT Introduction: Bone marrow edema (BME) is a rare and self-limiting condition characterized by bone pain and increased interstitial fluid in the bone marrow. The most common areas of BME are the bones of the hip, knee, ankle and foot. It was aimed to reveal the effectiveness of intravenous Iloprost (IVI) treatment by evaluating the MR images and pain of patients with lower extremity bone marrow edema (LEBME). Materials and Method: A total of 56 patients, who were followed up retrospectively for lower limb bone marrow edema were included in the study.14 patients were advised not to bear weight on the effected limb, 42 patients were given ilioprost infusion and were advised not to bear weight on the effected limb. Patients who received iloprost treatment were admitted to our service and monitorized while 1 ampule of Iloprost (20mcg / ml) was administered for 6 hours via a slow infusion for 5 days. The evaluation of the MRI and Visual Analogue Scale (VAS) results were done before and 6 weeks after the treatment. Results: In our clinic, 14 (25%) of the patients who were followed up with LEBME constituted the control group (followed with non-weight bearing treatment), and 42 (75%) of the patients were the other group (treated with intravenous iloprost + non-weight bearing treatment). The average age of patients included in the study were 47, 7 years old, 53,6% were males and 46.4% were females. Forty-five (80,4%) of the participants of the study had MR results before treatment and all of them were identified as ARCO stage1. After the treatment 39 (69,6%) of the patients' MR results were accessed. After treatment 1 (2,5%) patient, ARCO was stage 1, and 38 (97.5%) patients were identified as ARCO stage 0. The mean duration of complaints of the patients was 13, 96 months, and the mean VAS score before treatment was 8, 23 ± 1.56 (mean ± SD), and the mean after-treatment VAS score was 3.36 ± 2.34 (mean ± SD). Conclusion: All patients who were followed-up with LEBME, regardless of IVI treatment, showed a significant improvement in their VAS scores. There was no significant clinical and radiological difference between these two treatment protocols. The number of patients in the control group is less than that of the patients receiving iloprost treatment, and different results may occur in studies with larger sample.