EURORAD ESR

Case 2181

Avascular necrosis in sickle cell disease

Author(s)
Scutellari PN, Cinotti A, Cuneo A, Mannella P
 
Patient
male, 30 year(s)
 
 
  • Figure 1
    Radiographic imaging
     

    Digital radiography of the knee: bone infarction is present in the metadiaphyseal region of both femora and tibiae. On the articular surface of the medial femoral condyle: a crescent cortical radiolucency, referred to...

     
    Area of Interest: unknown; Imaging Technique: Radiographic imaging;

    Radiography of the hip: avascular necrosis occurs in the proximal femoral epiphysis; radiographic findings consist of subarticular lucency (crescent sign), followed by collapse of the joint surface, and areas of...

     
    Area of Interest: unknown; Imaging Technique: Radiographic imaging;

    Digital radiography of the shoulder: alteration of bone texture is seen in the humeral head, consisting of lytic and sclerotic lesions (mixed type); a crescent sign is also seen. The joint space is not affected.

     
    Area of Interest: unknown; Imaging Technique: Radiographic imaging;
     
     
  • Figure 2
    MR Imaging
     

    Coronal SE T1-weighted image reveals marrow reconversion in the femoral distal and proximal tibial metaphyses. Other analogous areas of marrow reconversion are present in the epiphyses (normally fatty). In the medial...

     
    Area of Interest: unknown; Imaging Technique: MR Imaging;

    Sagittal GE T2*-weighted and STIR images confirm the same findings as Figure 2a. A focus of osteonecrosis demonstrates a characteristic high signal inner rim.

     
    Area of Interest: unknown; Imaging Technique: MR Imaging;

    Coronal SE T1-weighted, GE T2*-weighted and STIR imaging shows a geographical-like lesion in the proximal tibial metaphysis, with focal increased signal intensity related to bone marrow oedema in avascular necrosis

     
    Area of Interest: unknown; Imaging Technique: MR Imaging;

    Coronal SE T1-weighted imaging reveals a focal region of diminished signal intensity on the humeral head.

     
    Area of Interest: unknown; Imaging Technique: MR Imaging;

    Coronal GE T2*-weighted and STIR images: marrow reconversion and subchondral oedema, without cortical collapse (the crescent sign).

     
    Area of Interest: unknown; Imaging Technique: MR Imaging;
     
     
Digital radiography of the knee: bone infarction is present in the metadiaphyseal region of both femora and tibiae. On the articular surface of the medial femoral condyle: a crescent cortical radiolucency, referred to as avascular necrosis.
 
Radiography of the hip: avascular necrosis occurs in the proximal femoral epiphysis; radiographic findings consist of subarticular lucency (crescent sign), followed by collapse of the joint surface, and areas of sclerosis within the epiphysis. Marked flattening, cystic changes and secondary degenerative lesions are seen: "buttressing" is present on the medial aspect of the left femoral neck.
 
Digital radiography of the shoulder: alteration of bone texture is seen in the humeral head, consisting of lytic and sclerotic lesions (mixed type); a crescent sign is also seen. The joint space is not affected.
 
Coronal SE T1-weighted image reveals marrow reconversion in the femoral distal and proximal tibial metaphyses. Other analogous areas of marrow reconversion are present in the epiphyses (normally fatty). In the medial femoral condyle, moreover, a small focus of osteonecrosis is present.
 
Sagittal GE T2*-weighted and STIR images confirm the same findings as Figure 2a. A focus of osteonecrosis demonstrates a characteristic high signal inner rim.
 
Coronal SE T1-weighted, GE T2*-weighted and STIR imaging shows a geographical-like lesion in the proximal tibial metaphysis, with focal increased signal intensity related to bone marrow oedema in avascular necrosis
 
Coronal SE T1-weighted imaging reveals a focal region of diminished signal intensity on the humeral head.
 
Coronal GE T2*-weighted and STIR images: marrow reconversion and subchondral oedema, without cortical collapse (the crescent sign).
 
 
 
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