APPARENT FOCAL BONE-MARROW ISCHEMIA IN PATIENTS WITH MARROW DISORDERS- MR STUDIES

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.