title: Treatment of bone marrow edema of the talus with pulsed electromagnetic fields: outcomes in six patients.
abstract: BACKGROUND
  Bone marrow edema (BME) of the talus is a rare, mostly self-limiting cause of foot and ankle pain. We sought to investigate in patients with idiopathic BME of the talus the effectiveness of pulsed electromagnetic fields and to determine the effect of this therapy on magnetic resonance imaging findings.
  
  
  METHODS
  Six patients with BME of the talus confirmed by magnetic resonance imaging were enrolled. Pain was quantified with a visual analog scale from 0 (no pain) to 10 (the worst pain imaginable). The clinical outcome was assessed using the American Orthopaedic Foot and Ankle Society scoring system. Treatment consisted of pulsed electromagnetic field stimulation 8 h/d for 30 days. The device used generated pulses 1.3 milliseconds in duration, with a frequency of 75 Hz and a mean ± SD induced electric field of 3.5 ± 0.5 mV.
  
  
  RESULTS
  The mean American Orthopaedic Foot and Ankle Society score improved from 59.4 (range, 40-66) before treatment to 94 (range, 80-100) at the last follow-up. The visual analog scale score decreased significantly from 5.6 (range, 4-7) before treatment to 1 (range, 0-2) at the last follow-up. Magnetic resonance imaging showed that BME improved after 1 month of treatment and resolved completely within 3 months in 5 patients, with normal signal intensity and no signs of progression to avascular necrosis.
  
  
  CONCLUSIONS
  A significant reduction in BME area was associated with a significant decrease in pain within 3 months of beginning treatment.
authors: Nicolò
authors: N
authors: Martinelli
authors: Alberto
authors: A
authors: Bianchi
authors: Elena
authors: E
authors: Sartorelli
authors: Alessandra
authors: A
authors: Dondi
authors: Carlo
authors: C
authors: Bonifacini
authors: Francesco
authors: F
authors: Malerba
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D001853:Bone Marrow / Q000473:pathology*; D001855:Bone Marrow Diseases / Q000150:complications / Q000473:pathology / Q000628:therapy*; D004487:Edema / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055909:Magnetic Field Therapy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013628:Talus / Q000473:pathology*; D016896:Treatment Outcome