Sickle cell disease (skeletal manifestations)
Skeletal manifestations of sickle cell disease result from a combination of bone marrow hyperplasia in the setting of chronic anaemia, and bone infarction as well as their complications.
For a general discussion of sickle cell disease, please refer to sickle cell disease.
Bone pain is a frequent complaint, although vaso-occlusive events may also be silent.
- marrow hyperplasia
- bone infarcts typically involve medullary cavities and epiphyses
- the proximal humeri, proximal femora, and vertebral bodies are often affected
- in the humeri, serpiginous sclerosis is characteristic of infarction
- vertebral infarcts may result in
dactylitis also known as hand-foot syndrome
- early manifestation of sickle cell disease in first two years of life which results from bone infarcts in the diaphysis of small long bones
- imaging findings include patchy areas of lucency with periostitis and soft tissue swelling of metacarpals or metatarsals which could be difficult to distinguish from osteomyelitis 4
- growth disturbance
- 1. Lonergan GJ, Cline DB, Abbondanzo SL. Sickle cell anemia. Radiographics. 21 (4): 971-94. Radiographics (full text) - Pubmed citation
- 2. Ejindu VC, Hine AL, Mashayekhi M et-al. Musculoskeletal manifestations of sickle cell disease. Radiographics. 27 (4): 1005-21. doi:10.1148/rg.274065142 - Pubmed citation
- 3. Stoller DW, Tirman PF, Bredella MA. Diagnostic imaging, Orthopaedics. Amirsys Inc. (2004) ISBN:0721629202. Read it at Google Books - Find it at Amazon
- 4. Espinosa GA. Hand-foot roentgen findings in sickle cell anemia. J Natl Med Assoc. 1979;71 (2): 171-3. Free text at pubmed - Pubmed citation
Metabolic bone disease
- bone mineralisation
- osteosclerosis (differential diagnosis / mnemonic)
- pituitary gland-related
- thyroid gland-related