Gelatinous marrow transformation, also known as serous atrophy of bone marrow, refers to a marrow disorder that occurs with chronic illness and poor nutritional status. It is characterized by atrophy of the fatty marrow and loss of hematopoietic cells, replaced by extracellular gelatinous substances.
It is important to be aware of this condition so as not to subject the patient to a repeat MRI out of concern that the study is technically faulty.
This may be seen with:
- anorexia nervosa or other eating disorders
- acute febrile illness
- congestive heart failure
- myelodysplastic syndrome
Fluid intensity regions in the marrow that are initially patchy but become confluent. These progress in the same order as red to yellow marrow conversion: distal extremities to proximal extremities and axial skeleton. Similar signal abnormalities can usually be observed in the adjacent subcutaneous fat 6.
- T1: mildly low signal intensity
- fat-suppressed fluid-sensitive sequences (e.g. T2 fat-sat, STIR, SPAIR): high signal intensity
NB: gelatinous marrow transformation is often associated with insufficiency fractures, which may be obscured on MRI by the abnormal bone marrow signal.
CT can be used as a problem-solving tool in case of a clinical suspicion of an insufficiency fracture that cannot be visualized properly on MRI.
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