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MRI findings of serous atrophy of bone marrow and associated complications

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To report the MRI appearance of serous atrophy of bone marrow (SABM) and analyse clinical findings and complications of SABM.

Methods

A retrospective search of MRI examinations of SABM was performed. Symptoms, underlying conditions, MRI findings, delay in diagnosis and associated complications were recorded.

Results

We identified 30 patients (15 male, 15 female; mean age: 46 ± 21 years) with MRI findings of SABM. Underlying conditions included anorexia nervosa (n = 10), cachexia from malignant (n = 5) and non-malignant (n = 7) causes, massive weight loss after bariatric surgery (n = 1), biliary atresia (n = 1), AIDS (n = 3), endocrine disorders (n = 2) and scurvy (n = 1). MRI showed mildly hypointense signal on T1- weighted and hyperintense signal on fat-suppressed fluid-sensitive images of affected bone marrow in all cases and similar signal abnormalities of the adjacent subcutaneous fat in 29/30 cases. Seven patients underwent repeat MRI due to initial misinterpretation of bone marrow signal as technical error. Superimposed fractures of the hips and lower extremities were common (n = 14).

Conclusions

SABM occurs most commonly in anorexia nervosa and cachexia. MRI findings of SABM are often misinterpreted as technical error requiring unnecessary repeat imaging. SABM is frequently associated with fractures of the lower extremities.

Key points

• SABM occurs in several underlying conditions, most commonly anorexia nervosa and cachexia.

• Abnormal marrow signal is often misinterpreted as technical error requiring unnecessary repeat imaging.

• SABM is frequently associated with stress fractures.

• Fractures in SABM can be obscured by marrow signal abnormality on MRI.

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Acknowledgments

We would like to acknowledge Dr. Donald J. Flemming of Hershey, PA; Dr. Devon A. Klein of New York, NY; Dr. Mini Pathria of San Diego, CA; Dr. Jeffrey D. Stanczak of Salisbury, NC and Dr. Daniel M. Walz of Great Neck, NY, USA for their help with the manuscript.

The scientific guarantor of this publication is Miriam A. Bredella. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, cross-sectional study, multicentre study.

Author information

Authors and Affiliations

  1. Department of Radiology, 4860 Y St., Suite 3100, UC Davis, Sacramento, CA, 95817, USA

    Robert D. Boutin

  2. Joint Department of Medical Imaging, Toronto General Hospital, University of Toronto, PMB Rm 1-549, 585 University Ave, Toronto, ON, M5G 2N2, Canada

    Lawrence M. White

  3. Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA

    Tal Laor

  4. Department of Radiology, New England Baptist Hospital, 125 Parker Hill Avenue, Converse 2, Boston, MA, 02120, USA

    Damon J. Spitz

  5. Diagnostic Radiology, Carolinas HealthCare System, Charlotte Radiology, 3816 Latrobe Drive, Charlotte, NC, 28211, USA

    Robert R. Lopez-Ben

  6. Department of Radiology, Stanford University, 300 Pasteur Drive, S062A Grant Building MC 5105, Stanford, CA, 94305, USA

    Kathryn J. Stevens

  7. Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, YAW 6048, Boston, MA, 02114, USA

    Miriam A. Bredella

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  1. Robert D. Boutin
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  2. Lawrence M. White
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Correspondence to Miriam A. Bredella.

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Boutin, R.D., White, L.M., Laor, T. et al. MRI findings of serous atrophy of bone marrow and associated complications. Eur Radiol 25, 2771–2778 (2015). https://doi.org/10.1007/s00330-015-3692-5

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  • DOI: https://doi.org/10.1007/s00330-015-3692-5

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