Susceptibility-weighted imaging findings in a patient with systemic cobalt toxicity

Systemic manifestations of cobalt toxicity include neurological, cardiac, and endocrine dysfunction. Neuroimaging findings in patients with cobalt intoxication are not well characterized.

A 45-year-old woman developed bilateral sensorineural hearing loss after undergoing revision total hip arthroplasty and was subsequently diagnosed with cobalt toxicity. She underwent a second revision total hip arthroplasty, but her hearing loss persisted. As part of her otolaryngology evaluation, magnetic resonance imaging of the internal auditory canals was performed. Susceptibility-weighted imaging sequences on magnetic resonance imaging revealed increased mineralization in the basal ganglia and midbrain.

Susceptibility-weighted imaging, which uses magnetic properties of tissues to enhance imaging, can detect mineral deposition in the brain. Since cobalt is magnetic, its brain deposition may be identified on susceptibility-weighted imaging, but the clinical implications of this are unclear.

Magnetic resonance imaging abnormalities, including mineralization on susceptibility-weighted imaging sequences, may occur in patients with systemic cobalt toxicity. Further research efforts may clarify the clinical significance of these abnormalities in cobalt-poisoned individuals.