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Beyond the Signal: Imaging Insights and Diagnostic Relevance of Bone Oedema in Bone Tumours and Tumour-like Lesions
1
Department of Radiology, Leicester Royal Infirmary, University Hospitals Leicester, Leicester LE1 5WW, UK
2
Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital, Birmingham B31 2AP, UK
3
Department of Radiology, Nottingham University Teaching Hospital NHS Trust, Nottingham NG7 2GT, UK
4
Department of Radiology, AIG Hospital, Hyderabad 500032, India
*
Author to whom correspondence should be addressed.
Cancers 2025, 17(13), 2074; https://doi.org/10.3390/cancers17132074
Submission received: 27 May 2025
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Revised: 13 June 2025
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Accepted: 19 June 2025
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Published: 20 June 2025
(This article belongs to the Special Issue Sarcoma Management in Orthopaedic Oncology)
Simple Summary
Bone oedema, both within and on the surface of a bone, is a reactive process which occurs in a range of conditions, from benign to malignant. Using different imaging techniques, the volume, pattern and anatomic location of this oedema can be assessed. This can guide the radiologist and clinical team towards the underlying diagnosis, and therefore direct the most appropriate treatment for the patient. In this review, we discuss the different imaging techniques used in assessing bone oedema, their pros and cons, and imaging appearances of various conditions, with a focus on bone oedema. Finally, we describe how the pattern of bone oedema can provide information about how a patient’s cancer is responding to treatment.
Abstract
Bone oedema is associated with a wide spectrum of pathologies, including inflammation, infection, trauma, and neoplasms. The imaging characteristics of bone oedema in the context of an osseous tumour or tumour-like lesion can help narrow the aetiological differential and, when combined with specific MRI sequences or additional imaging modalities, may even suggest the precise underlying diagnosis. In this review, we discuss the various imaging modalities used in the detection and characterisation of bone oedema, briefly describe histopathological correlate of this finding, and detail the imaging features of a range of benign and malignant lesions that are classically associated with bone oedema. Finally, we explore the role of bone oedema in assessing treatment response, in relation to chemotherapy and radiotherapy.
Keywords:
magnetic resonance imaging; MRI; bone; Oedema; bone tumour
