Sickle cell anaemia

Case contributed by Dr Paul Simkin

Presentation

Palpitations and dizziness. Known history of sickle cell disease.

Patient Data

Age: 55
Gender: Male
Modality: X-ray

The heart is enlarged with a cardiothoracic ratio of 0.57. The lungs and pleural spaces are clear. No pneumothorax or free subdiaphragmatic gas.

The bowel gas in the left subdiaphragmatic area is laterally located, without a convincing evidence of splenic shadow. 

Bilateral humeral head bone infarcts, and mildly H-shaped vertebral bodies is consistent with a history of sickle cell anaemia.

Modality: CT

No pulmonary embolism identified. No regions of focal consolidation. No pleural effusions. No focal parenchymal nodules.

Focal sclerosis in the right humeral head noted.

The thoracic skeleton is diffusely abnormal with areas of sclerosis and lucency within the ribs and vertebral bodies. Multiple vertebral bodies demonstrate central end-plate collapse (H-shaped).

The spleen has undergone presumed autoinfarction and all that remains is a focal area of clumped calcification in the left upper quadrant.

Conclusion:

No pulmonary embolus identified. No features of a pulmonary infarct.

Splenic autoinfarction.

Diffuse skeletal disease consistent with the known history of sickle cell disease with multifocal regions of sclerosis consistent with prior episodes of bone infarct.

Case Discussion

Typical features of sickle cell disease on imaging. These images make up good cases for fellowship radiology exams as one can spot multiple findings to come up with a unifying diagnosis. 

PlayAdd to Share

Case Information

rID: 29398
Case created: 22nd May 2014
Last edited: 29th Nov 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.