B. Vandeberg et al., APPARENT FOCAL BONE-MARROW ISCHEMIA IN PATIENTS WITH MARROW DISORDERS- MR STUDIES, Journal of computer assisted tomography, 17(5), 1993, pp. 792-797
Objective: We sought to assess with MR the focal bone marrow abnormali
ties in patients with chronic marrow disorders and acute limb pain. Ma
terials and Methods: We investigated and followed with MRI four patien
ts with proliferative or dysplastic marrow disorders presenting with a
cute but spontaneously resolving hip or thigh pain. Results: Ten focal
marrow lesions were demonstrated on T2-weighted images as high signal
intensity (SI) areas. They remained undetected on T1-weighted images
as they showed a low SI similar to the disease-related low SI of the e
ntire marrow. Postcontrast images demonstrated lack of enhancement in
the lesions. Follow-up enhanced MR images showed intense enhancement w
ithin the lesions, while unenhanced MR images remained unchanged. Late
r on, these focal marrow abnormalities completely resolved. These lesi
ons most likely represent bone marrow ischemia, although histological
proof is lacking. Conclusion: Acute bone pain in patients with bone ma
rrow disorders may be related to focal marrow lesions suggestive of bo
ne marrow ischemia.