Sickle cell disease with osseous changes and splenomegaly

Case contributed by Dr Vikas Shah

Presentation

Acute abdominal pain in a young man with a known chronic disorder.

Patient Data

Age: 20
Gender: Male

There are FOUR specific findings of sickle cell disease on this single bone window coronal CT:

  1. splenomegaly - the pain was thought to be due to an acute sequestration crisis
  2. patchy bone sclerosis
  3. avascular necrosis of the right femoral head - flattening with subarticular sclerosis and fragmentation
  4. H-shaped vertebral body - reflecting end-plate micro-infarcts

This annotated image shows the findings of sickle cell disease:

  1. splenomegaly - the pain was thought to be due to an acute sequestration crisis
  2. patchy bone sclerosis
  3. avascular necrosis of the right femoral head - flattening with subarticular sclerosis and fragmentation
  4. H-shaped vertebral body - reflecting end-plate micro-infarcts

Other findings that may be seen on abdominal imaging (and particularly in radiology exam cases) are gallstones, cholecystectomy clips, and splenic atrophy.

Case Discussion

Chest and abdominal images of sickle cell disease are a real radiology exam favourite - there are often multiple findings which add up to the overall diagnosis.

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Case information

rID: 47444
Case created: 16th Aug 2016
Last edited: 19th Aug 2016
Inclusion in quiz mode: Included

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