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This Article Full Text Full Text (PDF) All Versions of this Article: 35/6/990    most recent 0363546506297059v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Boks, S. S. Articles by Bierma-Zeinstra, S. M. A. Search for Related Content PubMed PubMed Citation Articles by Boks, S. S. Articles by Bierma-Zeinstra, S. M. A. Related Collections Imaging Studies Knee

Clinical Consequences of Posttraumatic Bone Bruise in the Knee

Simone S. Boks, MD^,,*, Dammis Vroegindeweij, MD, PhD, Bart W. Koes, PhD, Roos M. D. Bernsen, PhD^,||, M.G. Myriam Hunink, MD, PhD^¶,# and Sita M. A. Bierma-Zeinstra, PhD

From the Department of Radiology, Diaconessenhuis Meppel, the Netherlands, Department of General Practice, Erasmus MC, Rotterdam, the Netherlands, Department of Radiology, Medical Centre Rijnmond-Zuid, Rotterdam, the Netherlands, ^|| Department of Community Medicine, United Arab Emirates University, Al Ain, United Arab Emirates, ^¶ Department of Radiology, and ^# Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam, the Netherlands

^* Address correspondence to Simone S. Boks, MD, Department of Radiology, Diaconessenhuis Meppel, P.O. Box 502, 7940 AM Meppel, the Netherlands (e-mail: s.boks{at}erasmusmc.nl).

Background: Bone bruise is often seen in posttraumatic knees, but the clinical relevance is unclear.

Hypothesis: The presence of bone bruise is associated with increased pain severity in patients with sustained knee trauma.

Study Design: Cohort study; Level of evidence, 2.

Methods: We collected prospective data of 132 patients visiting their general practitioner after sustained knee trauma. Patients with bone bruise underwent a magnetic resonance imaging follow-up study that was discontinued when the bone bruise could no longer be discerned or after 1 year of follow-up. Bone bruise was assessed on magnetic resonance imaging, and pain severity was scored on a numeric rating scale (0–10) at baseline, and at 3, 6, and 12 months after trauma. The presence of bone bruise and pain severity (over time) were compared using linear regression analyses for repeated measurements. Adjustment was made for possible confounders: presence of meniscal tears, cruciate or collateral ligament ruptures, severe effusion, osteoarthritis, obesity, age, gender, work load, and sports load.

Results: At baseline as well as during follow-up, bone bruise was associated with a slightly higher pain score. The differences, however, were very small (adjusted difference in pain severity 0.34 or less) and not statistically significant nor clinically relevant.

Conclusion: There is no statistically significant relationship, nor a clinically relevant relationship, between the presence of bone bruise and pain severity in patients with sustained knee injury in general practice.

Key Words: knee • trauma • bone bruise • pain • longitudinal study