IS case 538: Sickle cell associated bone infarcts/AVN - common locations and severity grading

Nate Johnson, MD

University of Rochester

Imaging Sciences URMC 2010
Publication Date: 2010-09-17

History

Patient is a 54-year-old male presenting with chronic left hip pain with acute worsening and no recent trauma.

Findings

See figures

Diagnosis

Sickle cell associated bone infarcts/AVN - common locations and severity grading

Discussion

Most Common Site of AVN in Sickle Cell Disease: 1) Femoral Head 2) Humeral Head 3) Vertebral Body 4) Other locations less common, but may occur anywhere.

Classification of Bone Infarct: 1) Stage 0 - Histological diagnosis. Radiograph/MRI normal. 2) Stage 1 - Abnormal MRI signal. Normal Radiograph. 3) Stage 2 - Radiograph abnormal (usually osteopenia or sclerosis). Symptomatic. 4) Stage 3 - Subchondral lucency/collapse. Normal joint space. 5) Stage 4 - Osteoarthritic changes with articular surface collapse.

References

  1. Manaster BJ, Roberts CC, Andrews CL, Petersilge C. Expert Differential Diagnosis: Musculoskeletal. Amirsys, 2008.

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