Bone marrow reconversion generates a red bone marrow pattern that is in reverse to the normal yellow-to-red distribution.
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Pathology
Bone marrow reconversion occurs when there is increased hematopoietic demand, which may be 1,2:
- physiological
- cigarette smoking
- obesity
- high endurance athletes
- high altitude
- post granulocyte-colony stimulating factor treatment
- pathological
- severe chronic anemia, e.g. sickle cell disease, thalassemia, hereditary spherocytosis
- diabetes mellitus
- chronic respiratory disease
Radiographic features
MRI
Signal intensity will be that of normal red marrow being low T1 signal but still higher than skeletal muscle 1,3. In the appendicular skeleton, it tends to be symmetrical and homogeneous, whereas in the axial skeletal it can be heterogeneous/multifocal 1. Marrow reconversion occurs in the reverse order of normal red to yellow marrow conversion 4.
Differential diagnosis
- if homogeneous consider diffuse marrow infiltration 1
- if heterogeneous consider 1