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Medullary bone infarcts

Case contributed by Townsville radiology training
Diagnosis almost certain
x-ray

Inhomogeneous densities within medullary cavity are in keeping with medullary infarcts. Minor disruption of ankle mortis.

mri

Multiple hyperintense lesions within the medullary cavity of the distal femur, proximal and distal tibia, distal fibula, talar domes all bilaterally with peripheral rim of low signal intensity. Note extension into epiphysis of proximal tibia and distal femora.  

Similar lesions are also noted involving the posterior aspect of calcaneum (bilateral) and right anterior beak of calcaneus, cuboid, naviculae and medial cuneiforms with some post contrast enhancement.

No marrow edema.

Case Discussion

Features of bilateral multiple medullary bone infarcts.

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