Chronic anemia - coarse trabecular pattern in bone

Case contributed by Mohammad walid Ahmad Amin
Diagnosis almost certain

Presentation

Left-hand pain after falling.

Patient Data

Age: 70 years
Gender: Female

Diffuse osteopenia with expansion of the medullary space of the forth metacarpal and a lace-like trabecular pattern.

Case Discussion

An elderly female presented to the ER complaining of left hand pain after falling. The x-ray was done to exclude a fracture. Her x-ray shows coarse trabecular bone changes with expansion of medullary space, especially at the fourth metacarpal of the left hand. This pattern has a wide differential diagnosis, one of which is chronic anemia, which was confirmed by laboratory tests in this patient.

If this pattern affects an isolated bone, this should raise the suspicion of neoplastic changes such as enchondromas.   

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