MRI findings of serous atrophy of bone marrow and associated complications

Robert D Boutin, Lawrence M. White, Tal Laor, Damon J. Spitz, Robert R. Lopez-Ben, Kathryn J. Stevens, Miriam A. Bredella

Research output: Contribution to journalArticle

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Abstract

Objectives: To report the MRI appearance of serous atrophy of bone marrow (SABM) and analyse clinical findings and complications of SABM. Methods: A retrospective search of MRI examinations of SABM was performed. Symptoms, underlying conditions, MRI findings, delay in diagnosis and associated complications were recorded. Results: We identified 30 patients (15 male, 15 female; mean age: 46 ± 21 years) with MRI findings of SABM. Underlying conditions included anorexia nervosa (n = 10), cachexia from malignant (n = 5) and non-malignant (n = 7) causes, massive weight loss after bariatric surgery (n = 1), biliary atresia (n = 1), AIDS (n = 3), endocrine disorders (n = 2) and scurvy (n = 1). MRI showed mildly hypointense signal on T1- weighted and hyperintense signal on fat-suppressed fluid-sensitive images of affected bone marrow in all cases and similar signal abnormalities of the adjacent subcutaneous fat in 29/30 cases. Seven patients underwent repeat MRI due to initial misinterpretation of bone marrow signal as technical error. Superimposed fractures of the hips and lower extremities were common (n = 14). Conclusions: SABM occurs most commonly in anorexia nervosa and cachexia. MRI findings of SABM are often misinterpreted as technical error requiring unnecessary repeat imaging. SABM is frequently associated with fractures of the lower extremities. Key points: • SABM occurs in several underlying conditions, most commonly anorexia nervosa and cachexia. • Abnormal marrow signal is often misinterpreted as technical error requiring unnecessary repeat imaging. • SABM is frequently associated with stress fractures. • Fractures in SABM can be obscured by marrow signal abnormality on MRI.

Original languageEnglish (US)
Pages (from-to)2771-2778
Number of pages8
JournalEuropean Radiology
Volume25
Issue number9
DOIs
StatePublished - Sep 10 2015

Fingerprint

Atrophy
Bone Marrow
Cachexia
Anorexia Nervosa
Lower Extremity
Scurvy
Biliary Atresia
Stress Fractures
Bariatric Surgery
Subcutaneous Fat
Hip Fractures
Weight Loss
Acquired Immunodeficiency Syndrome
Fats

Keywords

  • Cachexia
  • Gelatinous transformation of bone marrow
  • MRI
  • Serous atrophy of bone marrow
  • Stress fracture

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Boutin, R. D., White, L. M., Laor, T., Spitz, D. J., Lopez-Ben, R. R., Stevens, K. J., & Bredella, M. A. (2015). MRI findings of serous atrophy of bone marrow and associated complications. European Radiology, 25(9), 2771-2778. https://doi.org/10.1007/s00330-015-3692-5

MRI findings of serous atrophy of bone marrow and associated complications. / Boutin, Robert D; White, Lawrence M.; Laor, Tal; Spitz, Damon J.; Lopez-Ben, Robert R.; Stevens, Kathryn J.; Bredella, Miriam A.

In: European Radiology, Vol. 25, No. 9, 10.09.2015, p. 2771-2778.

Research output: Contribution to journalArticle

Boutin, RD, White, LM, Laor, T, Spitz, DJ, Lopez-Ben, RR, Stevens, KJ & Bredella, MA 2015, 'MRI findings of serous atrophy of bone marrow and associated complications', European Radiology, vol. 25, no. 9, pp. 2771-2778. https://doi.org/10.1007/s00330-015-3692-5
Boutin RD, White LM, Laor T, Spitz DJ, Lopez-Ben RR, Stevens KJ et al. MRI findings of serous atrophy of bone marrow and associated complications. European Radiology. 2015 Sep 10;25(9):2771-2778. https://doi.org/10.1007/s00330-015-3692-5
Boutin, Robert D ; White, Lawrence M. ; Laor, Tal ; Spitz, Damon J. ; Lopez-Ben, Robert R. ; Stevens, Kathryn J. ; Bredella, Miriam A. / MRI findings of serous atrophy of bone marrow and associated complications. In: European Radiology. 2015 ; Vol. 25, No. 9. pp. 2771-2778.
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abstract = "Objectives: To report the MRI appearance of serous atrophy of bone marrow (SABM) and analyse clinical findings and complications of SABM. Methods: A retrospective search of MRI examinations of SABM was performed. Symptoms, underlying conditions, MRI findings, delay in diagnosis and associated complications were recorded. Results: We identified 30 patients (15 male, 15 female; mean age: 46 ± 21 years) with MRI findings of SABM. Underlying conditions included anorexia nervosa (n = 10), cachexia from malignant (n = 5) and non-malignant (n = 7) causes, massive weight loss after bariatric surgery (n = 1), biliary atresia (n = 1), AIDS (n = 3), endocrine disorders (n = 2) and scurvy (n = 1). MRI showed mildly hypointense signal on T1- weighted and hyperintense signal on fat-suppressed fluid-sensitive images of affected bone marrow in all cases and similar signal abnormalities of the adjacent subcutaneous fat in 29/30 cases. Seven patients underwent repeat MRI due to initial misinterpretation of bone marrow signal as technical error. Superimposed fractures of the hips and lower extremities were common (n = 14). Conclusions: SABM occurs most commonly in anorexia nervosa and cachexia. MRI findings of SABM are often misinterpreted as technical error requiring unnecessary repeat imaging. SABM is frequently associated with fractures of the lower extremities. Key points: • SABM occurs in several underlying conditions, most commonly anorexia nervosa and cachexia. • Abnormal marrow signal is often misinterpreted as technical error requiring unnecessary repeat imaging. • SABM is frequently associated with stress fractures. • Fractures in SABM can be obscured by marrow signal abnormality on MRI.",
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AB - Objectives: To report the MRI appearance of serous atrophy of bone marrow (SABM) and analyse clinical findings and complications of SABM. Methods: A retrospective search of MRI examinations of SABM was performed. Symptoms, underlying conditions, MRI findings, delay in diagnosis and associated complications were recorded. Results: We identified 30 patients (15 male, 15 female; mean age: 46 ± 21 years) with MRI findings of SABM. Underlying conditions included anorexia nervosa (n = 10), cachexia from malignant (n = 5) and non-malignant (n = 7) causes, massive weight loss after bariatric surgery (n = 1), biliary atresia (n = 1), AIDS (n = 3), endocrine disorders (n = 2) and scurvy (n = 1). MRI showed mildly hypointense signal on T1- weighted and hyperintense signal on fat-suppressed fluid-sensitive images of affected bone marrow in all cases and similar signal abnormalities of the adjacent subcutaneous fat in 29/30 cases. Seven patients underwent repeat MRI due to initial misinterpretation of bone marrow signal as technical error. Superimposed fractures of the hips and lower extremities were common (n = 14). Conclusions: SABM occurs most commonly in anorexia nervosa and cachexia. MRI findings of SABM are often misinterpreted as technical error requiring unnecessary repeat imaging. SABM is frequently associated with fractures of the lower extremities. Key points: • SABM occurs in several underlying conditions, most commonly anorexia nervosa and cachexia. • Abnormal marrow signal is often misinterpreted as technical error requiring unnecessary repeat imaging. • SABM is frequently associated with stress fractures. • Fractures in SABM can be obscured by marrow signal abnormality on MRI.

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