Thalassemia - spine MRI

Case contributed by Dr Ian Bickle

Presentation

Known thalassemic with low back pain non responsive to simple analgesia.

Patient Data

Age: 30 years
Gender: Male
MRI

Diffusely low signal throughout the bony skeleton on both T1 and T2 sequences.

No intervertebral disc disease. 

Annotated image

Diffusely low signal throughout the bony skeleton on both T1 and T2 sequences.

Note the remarkable difference when compared to normal T1 and T2 marrow signal.

Case Discussion

Thalassemia is an autosomal recessive microcytic anemia that originated in the Mediterranean region. The genetic defect causes a reduction in the rate of globin chain synthesis which causes the formation of abnormal hemoglobin molecules.

The skeletal aspects of the disease are due to bone marrow proliferation consisting of expansion of the medulla, thinning of cortical bone, and resorption of cancellous bone resulting in a generalized loss of bone density.

This is often an incidental finding in on imaging before for other purposes.

The intensely low signal appearances on T1 and T2 is well illustrated in this otherwise normal study.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.