Marrow hyperplasia:
Widening of medullary spaces
Thinning of cortical bones, may result in pathologic fractures
Coarsening of trabeculae in long and flat bones
Osteopenia
Skull: widening of diploic spaces with thinning of inner and outer tables, osteoporosis, leading to "hair-on-end" appearance Facial bones are not usually involved
Spine: Cortical thinning and softening leads to fish-mouth vertebra
Extramedullary haemopoisis:
Less common in this disease (more common with hemolytic anemias)
Seen as intermediate signal on both T1 and T2
Hand foot syndrome (sickle cell dactylitis):
6 mnts to 2 years
Infarction of small bones
Present with tender and swollen hands and feet and fever
Seen in 50% of sickle cell anemia
Patchy areas of lucency with periosteal reaction
In severe cases bone destruction and deformity may be seen
Bone infarct:
Commonly affects long bones
Seen as patchy medullary lucency and sclerosis
Cortical infacrtion is seen as subperiosteal new bone with thickening of cortexor laminated, bone-within-bone appearance
AVN:
Common
Growth effects:
Growth arrest
Deformities
H-shaped vertebrae
Infection:
Commonly salmonella
Osteomyelitis more common than septic arthritis
Myonecrosis:
Soft tissue infection:
Protrusio acetabuli:
References:
1. Ejindu VC et al. Musculoskeletal Manifestations of Sickle Cell Disease. RadioGraphics 2007;27:1005-1021
