Widespread Osteonecrosis in Children With Leukemia Revealed by Whole-body MRI

• DOI: 10.1007/s11999-012-2579-x
• Publication Date: 2012-09-24T12:57:47Z
• Authors: Paivi Maria Miett...; Lucie Lafay-Cousin; Gregory M. T. Gui...; Alberto Nettel-Ag...; Vijay Moorjani
• Keywords: Male; Tibia; Osteonecrosis; Pain; Antineoplastic Agents; Humerus; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Magnetic Resonance Imaging; Severity of Illness Index; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Adrenal Cortex Hormones; Predictive Value of Tests; Child, Preschool; Asymptomatic Diseases; Humans; Female; Whole Body Imaging; Femur; Child; Epiphyses; Retrospective Studies

Background Confirmation of early long-bone epiphyseal osteonecrosis in pediatric patients with leukemia allows for medical and surgical intervention before articular surface collapse. MRI detects osteonecrosis, but multiple focused MR images are required to capture all lesions. Questions/purposes We determined whether whole-body (WB-MRI) could (1) assist diagnosing other osteonecroses, (2) characterize involvement, (3) detect preferential sites osteonecrosis. Patients Methods retrospectively reviewed prospectively collected data on 11 newly diagnosed who had musculoskeletal pain develop that persisted 4 weeks or more during treatment. All were screened by WB-MRI, which consisted a one-time scan the entire body. Osteonecrosis was defined as circumscribed lesions distinct rim low signal intensity normally high-intensity marrow T1-weighted high low-intensity short-tau inversion recovery images. Results WB-MRI confirmed nine patients. multisite lesions; eight lesions, comprised 66 129 (51%) involving greater than 50% present 57% distal femoral proximal tibial humeral head involved 1/3 medial volume asymptomatic. No collapse present. osteonecrotic common lower extremities. Conclusions quantification involvement. Lower limbs preferentially affected, asymptomatic five Level Evidence IV, diagnostic study. See Instructions Authors complete description levels evidence.