Case report: Treatment of bone marrow edema of femoral head with hyperbaric oxygen therapy

Abstract

Abstract Bone marrow edema syndrome is a rare condition of unclear etiology that is characterized by hip pain, limited osteopenia on plain radiography, and characteristic MRI findings. Although the etiology and pathogenesis of bone marrow edema syndrome are not currently known, different mechanisms have been proposed, including microvascular injury, venous obstruction, secondary localized hyperemia, abnormal mechanical stress, metabolic causes, neurogenic compression, etc. Hyperbaric oxygen therapy (HBO) appears to be effective in treating bone marrow edema syndrome, resulting in an accelerated recovery of hip function compared to pharmacological therapy alone. The primary effects of HBO in bone marrow edema are threefold. Firstly, by improving oxygen tension in tissue fluids at the site of bone necrosis, which prevents further loss of ischemic bone. Secondly, HBO-induced vasoconstriction decreases edema allowing better perfusion to the injury site, and thirdly, by enhancing reparative process by providing an improved oxygen environment for osteoclastic function, neovascularization and osteogenesis. Here, we report a case of bone marrow edema syndrome of hip in a 32-year-old male patient, which was conservatively managed.