Abstract
In order to evaluate the role of gadolinium-DOTA enhanced MRI in the management of painful osseous crises in children with sickle cell anemia (SCA), nine children with SCA underwent MRI, bone scans and ultrasonographic studies during 11 osseous crises. Imaging findings were compared with the final diagnosis: three acute osteomyelitis (AO) and 16 acute infarcts (AI). MRI could not differentiate AO from AI. The appearance of severe AI was very misleading and was similar to the usual appearance of AO, including soft tissue changes, periosteal reaction and patterns of enhancement. Gadolinium-DOTA enhanced MRI was useful for determining the anatomic site and extent of AO or AI and for distinguishing between necrotic material, fluid collection and vascularized inflammatory tissue. It can also help to guide the aspiration of intraosseous, subperiosteal and soft tissue fluid collections.
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References
Doppelt E, Rocque F de la, Morriet Y, Reinert P (1990) L'ostéomyelite chez le drépanocytaire. Arch Fr Pédiatr 47: 715–720
Moore SG, Sebag GH (1990) Primary disorders of bone marrow. In: Cohen MD, Edwards MK (eds) Magnetic resonance imaging of children. Decker, Philadelphia, 795–801
Fogelman I (1987) Bone scanning in clinical practice. Springer, Berlin Heidelberg New York, pp 163–165
Gold RH, Hawkins RA, Katz RD (1991) Bacterial osteomyelitis: findings on plain radiography, CT, MR, and scintigraphy. AJR 157:365–370
Kim HC, Abass A, Russel MO, Schwartz E (1989) Differentiation of bone and bone marrow infarcts from osteomyelitis in sickle cell disorders. Clin Nucl Med 14:249–254
Unger E, Moldofsky P, Gatenby R, Hartz W, Broder G (1988) Diagnosis of osteomyelitis by MR imaging. AJR 150:605–610
Dangman BC, Hoffer FA, Rand FF, O'Rourke E (1992) Osteomyelitis in children: gadolinium-enhanced MR imaging. Radiology 182:743–747
Cohen MD, Cory DA, Kleiman M, Smith JA, Broderick NJ (1990) Magnetic resonance differentiation of acute and chronic osteomyelitis in children. Clin Radiol 41:53–56
Rao VM, Mitchell DG, Rifkin MD, Steiner RM, Burk DL Jr, Levy D, Ballas SK (1989) Marrow infarction in sickle cell anemia: correlation with marrow type and distribution by MRI. Magn Res Imag 7:39–44
Vanzanten TEG, Stratius Van Eps LW, Golding RP, Valk J (1989) Imaging the bone marrow with magnetic resonance during a crisis and in chronic forms of sickle cell disease. Clin Radiol 40:486–489
Abiri MM, Kirpekar M, Ablow RC (1989) Osteomyelitis: detection with US. Radiology 172:509–511
Williamson SL, Seibert JJ, Glasier CM, Leithiser RE Jr, Aronson J (1991) Ultrasound in advanced pediatric osteomyelitis: a report of 5 cases. Pediatr Radiol 21:288–290
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Bonnerot, V., Sebag, G., de Montalembert, M. et al. Gadolinium-DOTA enhanced MRI of painful osseous crises in children with sickle cell anemia. Pediatr Radiol 24, 92–95 (1994). https://doi.org/10.1007/BF02020160
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DOI: https://doi.org/10.1007/BF02020160