Name : Morteza
Family :Sanei Taheri
Resident : Hussein Soleiman Tabar
Gender : Male
Age : 15
15 year old boy with no clinical history
Imaging Procedures and Findings
This is a known case of B-thalassemia. There is diffuse decrease in marrow signal ( as a result of red marrow conversion). Also liver and spleen show enlargement and decreased signal intensity of liver that could be due to iron overloading..
Skeletal changes in thalassaemia arise from the chronic anaemia associated with the condition.In the skull, there is widening of the diploic spaces (low signal on all MRI sequences) with thinning of the outer table of the skull vault. The trabecular markings are oriented perpendicular to the inner and outer tables and on plain radiographs this gives rise to the ??hair-on-endÃ¢?? appearance. There is frontal bossing and overgrowth of the facial bones with reduced pneumatization of the paranasal sinuses. The so-called ??rodent faciesÃ¢?? arises from marrow hyperplasia in the maxillae causing lateral displacement of the orbits and ventral displacement of the central incisors.In the spine there may be marked osteoporosis and cortical thinning resulting in fractures of the vertebral bodies and platyspondyly. Imaging may reveal paraspinal masses (as a result of extramedullary haematopoiesis). Cord compression can result if these masses extend into the extradural space. MRI findings are secondary to blood transfusion and chelation therapy.There may be expansion of the head and neck of the ribs and osteoporosis. A rib within a rib appearance may result. Extramedullary haematopoiesis can cause erosions of the inner cortex of the ribs or manifest as a posterior mediastinal soft tissue mass. Premature fusion of the growth plates (particularly of the proximal humerus and distal femur) is a recognized feature. Irregular sclerosis at the metaphyses and anterior rib ends is a recognized complication of treatment with desferrioxamine
Adam: Grainger & Allison's Diagnostic Radiology, 5th ed.