[5][9] Minor cases are usually treated through proper resting and taking non-steroidal anti-inflammatory drugs (NSAIDs), while steroid therapy or even surgery may be needed for more serious ones.

[15][16] Sex,[17][18] age, earlier immunosuppressive treatments,[19] or pre-existing physical trauma are all risk factors of bone marrow edema.

This is because it is commonly caused by inflammation and vascularization, resulting in displacement of bone marrow, originally rich in adipocytes, by hydrophilic material.

[2] These penetration sites allow the entry of inflammatory infiltrates, which could possibly be lymphocytic aggregates or invaded synovial tissue that are heavily vascularized, contributing to high water content in the bone marrow compartment.

[2] The increased hydrostatic pressure causes more fluid leakage out of the capillaries, and bone marrow edema is the direct result.

A common characteristic among bone marrow edema patients is the pain experienced, due to the aggravation of the neurovascular bundle by increased intraosseous pressure.

[6] Unfortunately, interdisciplinary guidelines and management algorithms regarding BME are currently underdeveloped, resulting in repetitive checking, delayed diagnosis or treatment.

[30] The cause is associated with active osteoporotic changes and low bone mineral density, which allows microfractures to occur in the affected region.

A study reported around one-third of tendinitis patients have bone marrow edema, and even all cases are revealed to be an uptake in isotope scans.

[32] Osteoarthritis is another disease that has a strong association with bone marrow edema due to mechanical loading, as well as stress on the subchondral region.

[23] Changes in connective tissue deposition such as uric acid composition in gout could cause bone marrow edema.

[39] Several common risk factors are listed as follows: Diagnosis of trabecular edema is primarily done via magnetic resonance imaging (MRI).

It is due to its ability to show any lesions or fractures in trabecular, subchondral or chondral structures, which aids physicians to understand if there are any underlying bone pathologies leading to the observed symptoms.

[13] A combination of core decompression with injection of hydroxyapatite cement into the tissue affected with bone marrow edema has been reported to significantly reduce pain levels.

Nonsteroidal anti-inflammatory drugs such as Iloprost, a medication that dilates arterial vascular beds, have been proven to aid in treating bone marrow lesions when administered in an intravenous manner, resulting in reduction of pain and restoration of functionality in affected areas.

For future research, more advanced study designs such as randomized clinical trials are needed to evaluate therapy by means of vitamin supplements.

Future studies should establish a standardised radiological score system to evaluate the areas of bone marrow edema.