Related Experiment Video
Updated: Mar 8, 2026
Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Diffuse phalangeal signal abnormality on magnetic resonance imaging: phalangeal microgeodic disease
Rupa Radhakrishnan1, Kathleen H Emery2, Arnold C Merrow2
1Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA. rupa.radhakrishnan@cchmc.org.
Background:
Phalangeal microgeodic disease is a rare and benign self-limited condition involving the phalanges, often in the setting of cold exposure, with characteristic MR imaging abnormalities. Radiographic case descriptions are predominantly from Asia and Europe, with only seven cases using MR to characterize phalangeal microgeodic disease.
Objective:
In this study we describe the MR imaging appearance of unusual and striking phalangeal signal abnormality compatible with phalangeal microgeodic disease at our institution in North America.
Materials And Methods:
We retrospectively reviewed cases presenting at our institution with unusual or unexplained phalangeal signal abnormalities between 2001 and 2014. We reviewed the MR imaging appearances in conjunction with radiographs and any other available imaging investigations.
Results:
Of 189 examinations reviewed during the study period, 8 imaging studies in 6 patients met the study inclusion criteria. Signal abnormality was present in 57 of 112 phalanges (51%), frequently involving the distal phalanges (70%, 28 of 40), followed by the middle phalanges (56%, 18 of 32) and the proximal phalanges (28%, 11 of 40). The pattern of involvement was most commonly diaphysis (38%), followed by metaphysis (32%) and epiphysis (30%). The extent of MR signal abnormality was greater than that suspected based on clinical presentation or on radiographs.
Conclusion:
The presence of unexplained diffuse characteristic marrow involvement of multiple painful phalanges on MR images, often in the setting of cold exposure, should raise the possibility of phalangeal microgeodic disease. Consideration of this diagnosis based on MR findings would lead to a more conservative management and avoid unnecessary invasive diagnostic procedures.
Insights
Phalangeal microgeodic disease, a rare condition causing painful phalanges, presents with characteristic MR imaging findings. Recognizing these MRI abnormalities can prevent unnecessary invasive procedures.
Area of Science:
- Radiology
- Orthopedic Imaging
- Musculoskeletal Radiology
Background:
- Phalangeal microgeodic disease is a rare, benign condition affecting the phalanges, often linked to cold exposure.
- Characteristic MR imaging findings are known, but documented cases, especially those using MRI, are scarce globally.
Purpose of the Study:
- To describe the MR imaging appearance of phalangeal microgeodic disease.
- To highlight unusual and striking phalangeal signal abnormalities consistent with this condition in North America.
Main Methods:
- Retrospective review of 189 examinations from 2001-2014 for unexplained phalangeal signal abnormalities.
- Analysis of MR imaging in conjunction with radiographs and other available imaging.
Main Results:
- Eight imaging studies in six patients met inclusion criteria.
- Signal abnormality was found in 51% of phalanges, most commonly distal and middle phalanges.
- MR imaging revealed a greater extent of abnormality than suggested by clinical presentation or radiographs.
Conclusions:
- Diffuse marrow involvement in multiple painful phalanges on MR imaging, especially with cold exposure history, suggests phalangeal microgeodic disease.
- Early recognition via MR findings can guide conservative management and avoid invasive diagnostics.
