Transient bone marrow oedema: a variant pattern of sacral insufficiency fractures.
A 71-year-old woman presenting with severe low back pain was found to have a large oval area of increased sacral uptake on Tc-99m MDP scan, with corresponding T1-hypointense and T2-hyperintense areas on magnetic resonance (MR) images, highly suggestive of malignancy. Open biopsies showed only callus formation. The patient responded clinically to conservative measures, with twice-repeated follow-up Tc-99m MDP and MR scans documenting resolution of transient bone marrow oedema. We suggest that this form of marrow oedema represents a variant pattern of sacral insufficiency fractures.
Peh
W C
WC
Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital. wcgpeh@hkucc.hku.hk
Cheng
K C
KC
Ho
W Y
WY
Chan
I K
IK
D000368:Aged; D001853:Bone Marrow / Q000473:pathology*; D004487:Edema / Q000473:pathology; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D019275:Radiopharmaceuticals; D012447:Sacrum / Q000293:injuries*; D016103:Spinal Fractures / Q000175:diagnosis*; D013669:Technetium Tc 99m Medronate; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate