Effectiveness of extracorporeal shock wave therapy in bone marrow edema syndrome of the hip

Cristina d’Agostino, Pietro Romeo, Vito Lavanga, Salvatore Pisani, Valerio Sansone

Research output: Contribution to journalArticlepeer-review


There is no gold standard for treatment of bone marrow edema syndrome of the hip (BMESH). Usually, treatment is conservative, owing to the favorable and self-limiting prognosis. In musculoskeletal disorders, the effectiveness of extracorporeal shock wave therapy (ESWT) has been widely recognized and recent research supports its use in the treatment of the first stages of avascular osteonecrosis of the proximal femur and in other conditions where bone marrow edema is present. On this basis, we performed a prospective study to evaluate the effectiveness of ESWT in normalizing the symptoms and imaging features of BMESH. Twenty consecutive symptomatic patients underwent two treatments of high-energy ESWT and were followed-up at 2, 3 and 6 months, with a final clinical follow-up at mean 15.52 ± 1.91 months. Patients underwent magnetic resonance imaging of the hip and were evaluated according to the Harris hip score. The mean improvement in HHS over the course of the study was of 58.5 ± 14.9 points (p 2 pre-treatment to 107.8 ± 248.1 mm2 at 6 months. ESWT seems to be a powerful, non-pharmacological tool that produces rapid pain relief and functional improvement and aids the normalization of the vascular and metabolic impairments which characterize BMESH.

Original languageEnglish
Pages (from-to)1513-1518
Number of pages6
JournalRheumatology International
Issue number11
Publication statusPublished - Nov 1 2014


  • Bone marrow edema syndrome
  • Conservative treatment
  • Extracorporeal shock wave therapy
  • Femoral head
  • Hip
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy
  • Medicine(all)


Dive into the research topics of 'Effectiveness of extracorporeal shock wave therapy in bone marrow edema syndrome of the hip'. Together they form a unique fingerprint.

Cite this