MASSIVE SUBCUTANEOUS AND INTRAOSSEOUS FAT NECROSIS ASSOCIATED WITH PANCREATITIS - NATURAL EVOLUTION OF THE RADIOGRAPHIC PICTURE

A 44-year-old man developed high fever, polyarthralgias, erythematous tender nodules and plaques on feet, ankles, knees and dorsum of the ha nds, as well as swelling of ankles and several joints of hands and fee t. Laboratory evaluation showed high serum pancreatic amylase and lipa se. Histological study of a subcutaneous nodule demonstrated fat necro sis. X-ray examination revealed numerous lytic lesions involving cance llous and cortical bone in phalanges, metacarpals, radius, tibia, tars us and metatarsals, with areas of widened bone. The patient never refe rred any abdominal symptom. He evolved favourably within the following months. A year later, resolution of most of the bone lesions was obse rved.