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Bone marrow oedema in heel bone

Discussion in 'Ask your questions here' started by David P, Feb 17, 2019.

  1. David P

    David P New Member

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    Hello All,

    An MRI scan has diagnosed me with mild bone marrow oedema in the plantar aspect of the calcaneous. I have the symptom on both feet for almost 8 weeks, and have been unable to walk or even stand for more than a few minutes. The last 4 weeks i have been using a CAM boot (mid-calf length) as instructed by a previous podiatrist, but have seen no improvement whatsoever. Walking with a limp has also given me other issues, and i've now developed insertional achilles tendonitis on both feet, as well as knee pain from the heavy CAM boots.

    My question is given my issue relates to heel bone bruising on the plantar aspect, whether i can use (as an alternative to the CAM boot) a well cushioned sports shoe (eg, running shoe) or one of those shorter/light weight post-op shoes with a rocker sole (eg, Darco short post op boots) possibly combined with a heel raise insert (for the achilles problem)? My previous podiatrist was insistent i use the CAM walker, but i worry my knees cannot take these too much longer, and to this stage the CAM boots which have a hard sole have not been particularly helpful possibly because my issue is bruising on the inferior calcaneous where *heel bone cushioning* should be the main concern, and not eg, an ankle issue requiring immobilization from the larger/more restrictive CAM boot?

    Many thanks.
    Last edited: Feb 17, 2019
  2. Craig Payne

    Craig Payne Active Member

    The CAM worker will be more effective than alternatives you mentioned.
    Bone marrow oedema is not necessarily due to a "cushioning" issue - given its going on for this long despite using the CAM walker, it probably needs some more investigation to see what is going on.
  3. David P

    David P New Member

    Hi Craig/All,

    Thanks for the response.

    - Are you able to provide a brief explanation/information on how the CAM boots can help with bone bruising on the plantar aspect of the heel bone? I've not been able to find any information to this point nor given any explanation by my previous podiatrist on how the heavy boots will aid me in this regard, only a generic response that i needed to wear a CAM boot for 'bone issues'. However with each step in the CAM boot, i find there is discomfort/pain on underside of heel bone suggesting i may benefit more from a shoe with more heel cushioning? Admittedly, the rocker sole does seem to take a little bit of pressure off the posterior heel. If there is good reasoning to use the CAM boot, perhaps i can get some crutches/wheelchair to allow me to at least move around house with less knee pain?

    - I've booked an appointment with another podiatrist (3rd one) later this week, but not sure if this is the right move, or whether i should look to see an orthopaedic surgeon? From an investigative standpoint, what things do you suggest i check for or ask? Should i take another MRI, or any other test? (last one was 4 weeks ago prior to wearing the cam boots).

    Many thanks.
  4. poddoc

    poddoc Guest

    The CAM boot can work in a couple of ways. It can limit motion of the ankle joint, and some of the other joints of the foot. It can also act as a "ball and chain" because you can't move around very fast, so you are reminded to take it easy because you are injured.

    A bone bruise will usually hurt at heel impact. A CAM walker is not very good at reducing impact. At this point, you could try a highly cushioned shoe to see if it relieves pain better than the CAM walker. The problem of a finding of bone marrow edema is that finding is non specific. From my chair, I have no idea what caused the edema. Going into soft shoes could make it worse, or better. You know what you got from being in a CAM walker. You could also try one of those knee scooters.

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