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37-year-old female underwent right knee MRI for evaluation of chronic right knee pain. There is a rounded T1 isointense to skeletal muscle, STIR hyperintense, nondiffusion restricting, mildly enhancing lesion abutting the posterior cortical margin of the proximal right tibial metaphysis. No cortical breakthrough or associated soft tissue mass. On out of phase images, there is no loss of signal. Imaging findings are most compatible with red or hematopoeitic marrow at that site. Bone marrow can be considered to have 3 components: red marrow, yellow marrow, and supporting structures. Red marrow is present throughout the skeleton at birth. In adults, red marrow is typically concentrated in the axial skeleton while yellow marrow is concentrated in the appendicular skeleton. Causes of red marrow proliferation include nonmedical conditions such as cigarette smoking and physical activity. Medical causes include obesity and respiratory related disorders, chronic conditions related to anemia, and patient's treated with hematopoeitic growth factors. NMR 312

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