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Acute bone infarction: a rare complication in thalassemia
Thanat Kanthawang1, Nuttaya Pattamapaspong2, Worawit Louthrenoo3
1Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Skeletal Radiology
|April 24, 2016
Summary
Acute bone infarction, a complication usually seen in sickle cell disease, can occur in thalassemia. This case highlights bone infarction in a patient with homozygous beta-thalassemia presenting with severe ankle pain.
Area of Science:
- Hematology
- Radiology
- Orthopedics
Background:
- Acute bone infarction is a known complication of sickle cell hemoglobinopathy.
- It is infrequently reported in patients with thalassemia.
- Thalassemia patients can present with symptoms mimicking infectious arthritis or osteomyelitis.
Purpose of the Study:
- To describe a case of acute bone infarction in a patient with homozygous beta-thalassemia.
- To discuss the characteristic magnetic resonance imaging (MRI) findings of bone infarction in this condition.
- To review the underlying etiologies of bone infarction in thalassemia.
Main Methods:
- Case report of an 18-year-old male with homozygous beta-thalassemia.
- Clinical presentation of fever and severe bilateral ankle pain.
- Magnetic resonance imaging (MRI) of the ankles and tibias.
- Review of literature on bone infarction in thalassemia.
Main Results:
- MRI revealed acute bone infarction in the meta-diaphysis of bilateral tibias.
- Imaging showed central unenhanced devitalized bone with T1-high signal intensity fluid in the subperiosteum and soft tissue.
- Fat suppression techniques on pre- and post-intravenous gadolinium T1-weighted images were beneficial.
Conclusions:
- Acute bone infarction can occur in homozygous beta-thalassemia, presenting as severe pain and fever.
- Characteristic MRI findings, particularly with fat suppression, aid in diagnosis.
- Understanding these imaging features is crucial for differentiating from infectious etiologies.
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