Marrow MR signal abnormality associated with bilateral avulsive cortical irregularities in a gymnast

Abnormal marrow signal and marrow enhancement have not been described in association with benign avulsive cortical irregularity. We present the case of an 11-year-old gymnast with such findings that partially resolved over time. The marrow MR abnormalities are believed to represent an extension or spectrum of findings associated with avulsive cortical irregularity, and should not instantly suggest infection or malignancy, as has been previously indicated. Careful and close clinical and radiological follow-up is required to confirm its benign course.