Bone marrow edema syndrome of the foot misdiagnosed as infection: Case report
Bibliographic record
Abstract
Bone marrow edema syndrome is a rare, self-limited clinical entity of unknown etiology and may be misdiagnosed as an infection. A 62-year-old man developed left foot pain with no prior trauma. Within 2 weeks, he was unable to walk because of increased pain. At 5 weeks, he developed left foot swelling. Radiographs showed midfoot osteopenia. He was treated for presumed gout and infection with nonsteroidal anti-inflammatory drugs, vancomycin, and ceftriaxone but had no improvement. Magnetic resonance imaging showed bone marrow edema and indistinct cortices. Single-photon emission computed tomography–computed tomography and bone scintigraphy showed intense osseous uptake, patchy demineralization, and erosive changes at the left midfoot. The diagnosis of bone marrow edema syndrome was made, based on review of imaging findings and persistent symptoms despite previous treatment. After treatment with analgesics and off-loading devices, he had complete resolution of pain and improvement of midfoot osteopenia by 5 months after symptom onset. In summary, bone marrow edema syndrome in the foot is rare, and awareness of this syndrome is necessary to avoid diagnostic error and unnecessary treatment. If magnetic resonance imaging is not available, single-photon emission computed tomography–computed tomography may be a useful adjunct toward the diagnosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.007 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".