Bone Marrow Edema in Rheumatic Diseases: Incidence, Diagnosis, and Therapeutic Implications. A Narrative Review.

Abstract: Bone Marrow Edema (BME) is a frequent imaging biomarker in several rheumatic diseases, reflecting subclinical inflammation, disease activity, and the risk of structural progression. This narrative review summarizes the prevalence, MRI characteristics, clinical relevance, and therapeutic implications of bone marrow edema (BME) in rheumatoid arthritis (RA), spondyloarthritis (SpA), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), gout, SAPHO syndrome, and complex regional pain syndrome type I (CRPS I). The manuscript was structured taking into consideration the seven domains of the International Narrative Systematic Assessment (INSA) tool, and an explicit literature search strategy is reported. Early detection of BME may guide clinical management, predict structural damage, and support monitoring of treatment efficacy. Standardized MRI assessment, integrated with clinical and laboratory data, enhances risk stratification and supports individualized therapeutic strategies.