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Craniofacial bone infarcts in sickle cell disease: clinical and radiological manifestations
Memi Watanabe1, Naoko Saito, Rohini N Nadgir
1Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA. memimd@hotmail.com
Objective:
To investigate the clinicoradiological manifestations of craniofacial bone infarcts in patients with sickle cell disease (SCD).
Materials And Methods:
After institutional review board approval, we identified 85 SCD patients who underwent head and neck magnetic resonance imaging (MRI) during a period of 5 years (January 1, 2004-December 31, 2008) and reviewed their clinical presentations and radiological findings.
Results:
Of 40 subjects with headache or facial pain, 6 (5 males, 1 female; age range, 2-22 years; 5 Hb SS, 1 Hb SC) were diagnosed with acute bone infarct by MRI. Of these 6, 4 demonstrated infarcts in the mandible. Magnetic resonance images showed bone marrow edema, subperiosteal fluid collections with susceptibility effects suggesting associated hemorrhage, and heterogeneous enhancement.
Conclusions:
Acute craniofacial bone infarcts were found in 7% of SCD patients who underwent MRI and in 15% of SCD patients who presented with pain. The MRI showed characteristic imaging findings including marrow edema, subperiosteal hematoma, and heterogeneous enhancement.
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