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Erdheim-Chester disease: diffusion-weighted imaging and dynamic contrast-enhanced MRI provide useful information

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Abstract

This is, to our knowledge, the first case report with in-depth analysis of bone marrow and bone lesions with diffusion-weighted imaging and dynamic contrast-enhanced MRI in Erdheim-Chester disease to date. We present a case of a 70-year-old woman who was referred for an X-ray of the pelvis, right femur and right knee after complaints of migratory arthralgia in hip and knee five months after an initial hip and knee trauma. Bone lesions on X-ray were identified. This case report highlights the strength and complementary use of modern multimodality multiparametric imaging techniques in the clinical radiological manifestations of Erdheim-Chester disease, in the differential diagnosis and in treatment response assessment, which is classically performed using 18FDG PET-CT. Erdheim-Chester disease is a rare form of non-Langerhans’ cell histiocytosis, mainly affecting individuals in their fifth-seventh decade of life and without sex predominance. Apart from the typical bilateral symmetric lesions in long bone diaphyseal and metaphyseal regions and classically sparing the epiphyses, this multisystemic disease causes significant morbidity by infiltrating critical organs (the central nervous system, cardiovascular system, retroperitoneum, lungs and skin). With non-traumatic bone pain being the most common complaint, Erdheim-Chester disease is diagnosed most often in an incidental setting on imaging. The imaging workup classically consists of a multimodality approach using conventional radiography, CT, MRI, bone scintigraphy and 18FDG PET-CT. This case report extends this evaluation with diffusion-weighted imaging and dynamic contrast-enhanced imaging techniques.

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Data Availability

Data (imaging and anonimyzed patient information from the electronic patient record) can be obtained at the data protection officer’s office of the data provider (Ghent University Hospital, Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium), in close collaboration with the Institutional Ethical Review Board.

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Authors and Affiliations

  1. Department of Radiology, Ghent University Hospital and Ghent University, Ghent, Belgium

    Thomas Van Den Berghe, Esther Candries, Nicolas Everaert & Koenraad Verstraete

  2. Department of Oncology, Ghent University Hospital and Ghent University, Ghent, Belgium

    Michael Saerens

  3. Department of Pathology, Ghent University Hospital and Ghent University, Ghent, Belgium

    Jo Van Dorpe

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  1. Thomas Van Den Berghe
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  2. Esther Candries
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  3. Nicolas Everaert
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Corresponding author

Correspondence to Thomas Van Den Berghe.

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All procedures performed in the study involving human participants are in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Van Den Berghe, T., Candries, E., Everaert, N. et al. Erdheim-Chester disease: diffusion-weighted imaging and dynamic contrast-enhanced MRI provide useful information. Skeletal Radiol 52, 1605–1618 (2023). https://doi.org/10.1007/s00256-022-04265-5

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  • DOI: https://doi.org/10.1007/s00256-022-04265-5

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