## 2 Applications
### Bme  
BME is defined as a condition characterized by an area of low signal intensity in T1- weighted and high signal intensity findings on T2-weightd on Magnetic Resonance Imaging (MRI) [6]. In the foot and ankle, the talus is the most affected foot bone [7]. This condition represents a nonspecific finding with multiple etiologies. Under physiological circumstances, high-intensity exercise triggers bone remodeling process. However, a repeated mechanical overload beyond a certain intensity can result in an incomplete remodeling process, and in an imbalance between bone apposition and absorption, with an alteration of the physiological trabecular bone architecture. This bone stress reaction results in pain and disability [8]. If adequately treated, BME resolves; in other conditions, it can also evolve towards bone necrosis. The rational for the use of PEMFs in the treatment of BME are based on two fundamental mechanisms of action: (1) PEMFs can play a role in the local inflammation control [9; 10] and (2) can enhance the healing process by stimulating neovascularization and new bone formation [11; 12]. [PERSON] et al. [7] investigated the effectiveness of PEMFs on patients with talar BME, determining their effect on MRI findings. BME reduced after 1 month of treatment and completely resolved within 3 months. Normal signal intensity and no signs of progression to avascular necrosis were reported, associated with a significant decrease in pain after 3 months. The mean American Orthopaedic Foot and Ankle Society (AOFAS) score improved from 59.4 (range, 40-66) before treatment to 94 (range, 80-100) at the last follow-up. The Visual Analog Scale (VAS) score decreased significantly from 5.6 (range, 4-7) before treatment to 1 (range, 0-2) at the last follow-up. This study confirms the evidences already reported on other joints. At the hip level, different authors described the use of PEMFs in the management of avascular necrosis of the femoral head in adults with positive results [13]. Results were evaluated using the Ficat classification. The Ficat classification stages osteonecrosis of the femoral head using a combination of plain radiographs, MRI, and clinical features: five different stages of bone necrosis are recognized, from Stage 0 to Stage 4 [14]. [PERSON] et al. [13] performed a systematic review reporting that early Ficat stages show the best responses to treatment via PEMFs with improvements in both clinical and radiographic parameters. Similarly, good outcomes were reported at the knee level: [PERSON] [15] et al. reported the results on spontaneous osteonecrosis of the knee in the early stage. Twenty-eight patients suffering from symptomatic Koshino I spontaneous osteonecrosis of the knee, confirmed by MRI, were treated with local PEMFs (6 h daily for 90 days). Pain, measured using the visual analog scale (VAS) (a 100-mm horizontal line, where the left end represents no pain, and the right end maximum possible or unbearable pain), significantly reduced at 6 months (from 73.2 \(\pm\) 20.7 to 29.6 \(\pm\) 21.3, \(p\)! 0.0001), which remained almost unchanged at the final follow-up (27.0 \(\pm\) 25.1). Knee society score (KSS) significantly increased in the first 6 months (from 34.0 \(\pm\) 13.3 to 76.1 \(\pm\) 15.9, \(p\)! 0.0001) and was slightly reduced at the final follow-up (72.5 \(\pm\) 13.5, \(p\) = 0.0044). Tegner median level increased from baseline to 6-month follow-up (1 (1-1) and 3 (3-4), respectively, \(p\)! 0.0001) and remained stable. EQ-5D (a standardized measure of health-related quality of life developed to provide a simple, generic questionnaire for use in clinical and economic appraisal and population health surveys) improved significantly throughout the 24 months (0.32 \(\pm\) 0.33, baseline; 0.74 \(\pm\) 0.23, 6-month follow-up (\(p\)! 0.0001); 0.86 \(\pm\) 0.15, 24-month follow-up (\(p\) = 0.0071)). Significant reduction in the total Whole-Organ Magnetic Resonance Imaging Score (WORMS) mean score (\(p\)! 0.0001) and mean femoral bone marrow lesion's area (\(p\)! 0.05) were observed.