Answer:
Bone Marrow Necrosis (BMN )
Findings:
Diffuse extensive and geographic pattern of Bone marrow signal abnormalities involving spine and pelvis . Central area of variable signal intensity surrounded by T2 hypointense rim , marrow edema and peripheral contrast enhancement.
Discussion:
Bone marrow necrosis (BMN) is unique and distinct from avascular necrosis (AVN) of bone and marrow aplasia. Histologically there is disruption of the normal marrow architecture and necrosis of myeloid tissue and medullary stroma with loss of fat spaces. It has been associated with malignancy (usually hematologic), sickle cell disease, infection, and medication or with Antiphospholipid Antibody syndrome as in our case The pattern of signal abnormalities in MRI have to be differentiated from AVN and bone infarcts . BMN is diffuse infiltrative , involving the marrow of the spine and pelvis, whereas Avascular Necrosis (AVN ) is usually more focal and found in a periarticular distribution , especially the femoral head, but rarely in the vertebrae. The lesions of BMN do not progress to vertebral body collapse, in contrast to vertebral AVN(Kummel`s Disease Bone infarcts are serpiginous low signal areas seen in long bones,but rarely in the vertebrae.
Ref : MRI Features of Bone Marrow Necrosis Yu Ming Tang et al - AJR February 2007vol. 188 no. 2 509-514
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai
Bone Marrow Necrosis (BMN )
Findings:
Diffuse extensive and geographic pattern of Bone marrow signal abnormalities involving spine and pelvis . Central area of variable signal intensity surrounded by T2 hypointense rim , marrow edema and peripheral contrast enhancement.
Discussion:
Bone marrow necrosis (BMN) is unique and distinct from avascular necrosis (AVN) of bone and marrow aplasia. Histologically there is disruption of the normal marrow architecture and necrosis of myeloid tissue and medullary stroma with loss of fat spaces. It has been associated with malignancy (usually hematologic), sickle cell disease, infection, and medication or with Antiphospholipid Antibody syndrome as in our case The pattern of signal abnormalities in MRI have to be differentiated from AVN and bone infarcts . BMN is diffuse infiltrative , involving the marrow of the spine and pelvis, whereas Avascular Necrosis (AVN ) is usually more focal and found in a periarticular distribution , especially the femoral head, but rarely in the vertebrae. The lesions of BMN do not progress to vertebral body collapse, in contrast to vertebral AVN(Kummel`s Disease Bone infarcts are serpiginous low signal areas seen in long bones,but rarely in the vertebrae.
Ref : MRI Features of Bone Marrow Necrosis Yu Ming Tang et al - AJR February 2007vol. 188 no. 2 509-514
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai