[Febrile osseous pain in children with sickle cell disease: MRI findings].
OBJECTIVE
The aim of this study was to report the MRI findings that can suggest a vaso-occlusive crisis in cases of febrile osseous pain in children suffering from sickle cell disease.


METHODS
MRI (T1 and T2 weighted sequences and T1 weighted sequence with fat saturation before and after gadolinium injection) was performed in 10 children with sickle cell disease, presenting with febrile osseous pain. The diagnosis of vaso-occlusive crisis was made after fast improvement due to symptomatic treatment and negative bacteriological result.


RESULTS
MRI was abnormal in all cases. A multifocal localisation was found in 2 cases. Bone marrow abnormalities were constant. In 10 cases, high T1 and T2 signal and metaphyso-diaphysial lesions were noted. Heterogeneous medullar enhancement with "ink stain" feature was constant. Early periosteal abnormalities were noted in 8 cases with inflammatory or stratified features. Cortical thinning was found in 1 case. Soft tissue abnormalities were observed in 5 cases with inflammatory features in 4.


CONCLUSIONS
Multifocal synchronous localisation, medullar abnormalities resulting from hemoglobin degradation, heterogeneous enhancement, early periosteal abnormalities and associated soft tissues swelling are MRI findings suggesting acute vaso-occlusive disease.
Aloui
N
N
Service de radiologie, Hôpital d'enfant de Tunis, Tunisie.
Nessib
N
N
Jalel
C
C
Ben Chehida
F
F
Zidi
A
A
Bellagha
I
I
Hendaoui
L
L
Abdallah
N B
NB
Railhac
J J
JJ
Ghachem
M
M
Hammou
A
A
D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000503:physiopathology; D001847:Bone Diseases / Q000175:diagnosis / Q000209:etiology*; D001855:Bone Marrow Diseases / Q000175:diagnosis; D001842:Bone and Bones / Q000098:blood supply / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D005334:Fever / Q000503:physiopathology; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010146:Pain / Q000503:physiopathology; D010522:Periostitis / Q000175:diagnosis; D014652:Vascular Diseases / Q000175:diagnosis / Q000209:etiology
D003287:Contrast Media; D005682:Gadolinium