The MRI says bone bruise. What does that mean?

What the radiologist is describing

Bone is not solid all the way through. Under the smooth cartilage there is a network of fine bone struts filled with marrow. A hard knock or a twisting injury can crush some of these struts and cause bleeding and swelling inside the bone. On MRI this appears as a bright, cloudy area, which radiologists call a bone bruise, bone contusion or bone marrow oedema.

It does not show on an ordinary X-ray, which is why X-rays are often normal after this kind of injury.

Why the location matters

• Outer thigh bone and back of the outer shin bone: a classic pattern after the knee shifts during an ACL tear
• Inner kneecap and outer thigh bone: typical after a kneecap dislocation
• Front of the shin bone and thigh bone: can follow hyperextension or a direct blow
• One area only after a fall onto the knee: often a direct impact bruise

So the report is read alongside the ligaments, meniscus and cartilage on the same scan.

What it means for you now

Bone bruises are painful, often with an ache that is worse on standing, walking or stairs, and sometimes at night. Most heal without surgery. Treatment usually involves reducing load for a period, with crutches if walking is painful, avoiding running and jumping, and keeping the knee moving with gentle exercises. Strengthening progresses as pain allows.

Smoking slows bone healing, and vitamin D levels are worth checking, as low levels are common in Qatar despite the sunshine.

Reviewing the MRI in Doha

Bring the images and the report to your appointment. At Aman Hospital Dr. Gelber reviews the scan himself, examines the knee for ligament or meniscus injury, and explains how long the bruise is likely to take to settle and what activity is safe in the meantime.