Sternal cupping: a new finding in childhood sickle cell anemia
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Discrete sternal cupping is a newly identified bone abnormality in children with sickle cell anemia (SCA) and sickle cell-hemoglobin C disease. Radiologists should recognize this benign finding to avoid misdiagnosis.
Area of Science:
- Pediatric Hematology
- Pediatric Radiology
- Skeletal Imaging
Background:
- Sickle cell anemia (SCA) is a genetic blood disorder associated with various bone abnormalities.
- Discrete sternal cupping has not been previously documented in pediatric patients with SCA.
Purpose of the Study:
- To report the novel finding of discrete sternal cupping in children with SCA and related hemoglobinopathies.
- To determine the prevalence of sternal cupping in this population.
- To inform radiologists about this benign finding.
Main Methods:
- Retrospective analysis of imaging studies in children diagnosed with sickle cell anemia or sickle cell-hemoglobin C disease.
- Evaluation for the presence and characteristics of sternal cupping.
Main Results:
- Discrete sternal cupping was observed in 8% of children with homozygous SCA.
- The phenomenon was present in 10.6% of children with sickle cell-hemoglobin C disease.
- Sternal cupping was a temporary finding with minimal clinical significance.
Conclusions:
- Discrete sternal cupping should be recognized as part of the spectrum of osseous abnormalities in sickle cell disease.
- Awareness of this finding can prevent misinterpretation as a more severe sternal pathology.
Abstract:
Discrete cupping of sternal segments has not been reported previously in children with sickle cell anemia (SCA). In a retrospective study, this phenomenon was observed in 8% of children with homozygous SCA and in 10.6% of children with sickle cell-hemoglobin C disease, and thus should be included in the spectrum of osseous abnormalities associated with this disease. In this review, sternal cupping was a temporary phenomenon of little clinical significance. However, radiologists should be aware of this finding so that it is not mistaken for a more serious pathologic process in the sternum.