title: Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome: MRI features of intraosseous fat necrosis involving the feet and knees.
abstract: Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is extremely rare and presents as a triad of the three diseases. The patient usually presents with mild or absent abdominal symptoms. Here, we report on a case of a 66-year-old male who presented with pain and swelling in both legs and mild abdominal pain. He was diagnosed with acute pancreatitis by pancreatic enzyme analysis and abdominal computed tomography (CT) and with skin lesions of panniculitis through a biopsy. Magnetic resonance imaging (MRI) revealed multifocal intraosseous fat necrosis and arthritis involving both the feet and the knees. Therefore, we report a case of PPP syndrome with intraosseous fat necrosis involving both the feet and the knees.
authors.affiliation: Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, 75 Bokjiro, Busanjin-gu, Busan, 614-735, South Korea.
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Kang
authors.affiliation: Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, 75 Bokjiro, Busanjin-gu, Busan, 614-735, South Korea. sunjulee98@gmail.com.
authors.forename: Sun Joo
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, 75 Bokjiro, Busanjin-gu, Busan, 614-735, South Korea.
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Choo
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Inje University College of Medicine, Busan Paik Hospital, Busan, South Korea.
authors.forename: Minyoung
authors.initials: M
authors.lastname: Her
authors.affiliation: Department of Pathology, Inje University College of Medicine, Busan Paik Hospital, Busan, South Korea.
authors.forename: Hye Kyoung
authors.initials: HK
authors.lastname: Yoon
mesh_terms: D015746:Abdominal Pain; D000368:Aged; D001168:Arthritis / Q000000981:diagnostic imaging*; D001706:Biopsy; D005218:Fat Necrosis / Q000000981:diagnostic imaging*; D005528:Foot / Q000000981:diagnostic imaging*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010195:Pancreatitis / Q000000981:diagnostic imaging*; D015434:Panniculitis / Q000175:diagnosis*; D013577:Syndrome; D014057:Tomography, X-Ray Computed
keywords: Fat Necrosis; MRI; Pancreatitis; Panniculitis; Polyarthritis