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Patient was scanned using the Gaucher protocol: Sagittal T1w and T2w images of the lumbar spine with coronal T1w and STIR images of the femur.
Lumbar Spine : There is a homogeneous pattern of reduced signal through the lumbar and lower thoracic vertebra and the sacrum with sparing of the fat around the basivertebral veins. Marrow is quite markedly reduced in signal with respect to the disc on the T2 weighted images and is isodense to disc on T1 weighted images. Modic type 1 degenerative changes noted on either side of the L5/S1 disc. No abnormal T2 signal elsewhere and no evidence of infarction.
Femur : An extensive pattern of signal abnormality through the femur is mildly heterogeneous. Signal abnormality extends to involve the capital femoral epiphyses and to a lesser extent the epiphyses of the greater trochanters bilaterally. There is also partial involvement of the distal femoral epiphyses. Patchy T2 signal is more extensive on the left than the right. At the margins of the images there is also increased the two signal within the proximal tibial diaphyses bilaterally. No evidence of osteonecrosis.
Conclusion: Extensive signal abnormality consistent with Gaucher infiltration. Of concern is the involvement of the proximal and distal femoral epiphyses which means she may be at risk of infarction at these sites. Likely early infarction through the diaphyses associated with increased T2 signal on the left.
Lumbar bone marrow burden score 5, femoral bone marrow burden score 8