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Natural History and Distribution of Bone and Bone Marrow Infarction in Sickle Hemoglobinopathies

Sam K. Kim, MD1 and John H. Miller, MD1,2

1 Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California
2 Childrens Hospital Los Angeles, Los Angeles, California



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  		FIGURE 1. Evaluation of 12-y-old boy with acute onset of right upper arm pain and swelling. (A) Early anterior skeletal-tissue-phase scintigram of upper torso immediately after administration of 99mTc-methylene diphosphonate reveals increased soft-tissue activity in right arm. (B) Delayed anterior skeletal scintigram of upper torso reveals increased radionuclide uptake in right humerus. (C) Anterior bone marrow scintigram reveals corresponding absence of bone marrow tracer activity in right humerus. (D and E) Anterior whole-body bone marrow (D) and anterior whole-body bone (E) scintigrams indicate acute infarct of right humerus. Healing infarcts in proximal and distal right tibia and healed bone marrow infarct in left radius are also seen.

 


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  		FIGURE 2. Total number of infarcts.

 


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  		FIGURE 3. Number of acute infarcts.

 


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  		FIGURE 4. Number of healed infarcts.

 


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  		FIGURE 5. Number of nonhealed infarcts.

 


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  		FIGURE 6. Number of infarcts (acute/total) in patients with sickle cell phenotype.

 




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