Known case of SLE, on treatment, presented with ankle pain.
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There are irregular serpigenous lines in medulla of distal tibia, fibula and posterior calcaneus. These lines appear hyperintense in T1 fat sat images in parallel with the hypointense thin lines within the marrow, suggestive of bone infarction.
Also noted hyperintensity edema in talus bone, and small osteochondral defect in medial aspect of talus dome , denoting osteochondritis dissicans.
Medullary bone infarction is a complication of long term steroid therapy in SLE patients.