Bone marrow oedema diagnosed 4 months ago in the shaft of 2nd metatarsal and cuneiform bones of my left foot after sudden onset of foot pain while walking. I have bilateral OA of 2nd TMT joints - worse on the right, relatively minor on the left. Worn an Aircast boot allowing protected walking. MRI repeated 2 weeks ago showing slight reduction in the bone marrow oedema only. Advised to walk short distances without boot - pain now worsened. NSAIDs not taken. Where do I go from here?
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Bone marrow oedema
The fact that you already have a diagnosis of osteoarthritis in the joint where you have the bone marrow edema may correlate with the findings of the MRI. It is still possible to have a stress fracture in this area and typically your physician reading the MRI can differentiate the difference between an acute osteoarthritic Flare vs a stress response in the bone. It seems as if the time spent in your boot was possibly too short and it may make sense to wean out of the boot a little slower in order to allow the inflammation more time to reduce in and around the involved joints. If it is in fact an arthritic flare, you may respond well to a short term Course of anti-inflammatory medication at the lowest possible dose. If indeed it is a stress response in the bone, you may respond better to continued rest and immobilization and it may make sense to have a vitamin D level drawn to determine if the stress response is related to deficiency in your bones ability to heal. Wish you well.
I would keep an open line of communication between you and your orthopedist and/or podiatrist. Edema is a sign of inflammation. Inflammation is part of healing, but sometimes anti-inflammatories such as NSAIDs or Tylenol may help to moderate the effects of inflammation. However, these medications are contraindicated in some patients and certain health conditions.
I hope this helps!!
I hope this helps!!