Serous Atrophy of Bone Marrow in the Feet Diagnosed via Magnetic Resonance Imaging: A Case Report.

IF 0.5 4区 医学 Q4 ORTHOPEDICS Journal of the American Podiatric Medical Association Pub Date : 2024-07-01 DOI:10.7547/22-189
George J Han, Ganesh M Joshi, Ryan Tai
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Abstract

Serous atrophy of bone marrow (SABM) is characterized by focal replacement of bone marrow elements with extracellular gelatinous substances. It has been associated with a wide range of chronic conditions, including anorexia nervosa, malignancy, chronic kidney disease, and certain chronic infections. Previous literature has reported the disorder as primarily diagnosed via bone marrow biopsy and occurring outside of the distal extremities. Herein we describe a case of SABM occurring in the feet diagnosed via magnetic resonance imaging (MRI), a phenomenon that is rarely reported. The patient is a 45-year-old woman with a history of end-stage renal disease, congestive heart failure, type 2 diabetes, and peripheral arterial disease who initially presented with nonhealing, bilateral foot ulcers. She subsequently underwent several podiatric medical surgeries due to persistent foot infections and poor wound healing. During her most recent hospitalization, MRIs of her feet were obtained, and findings of abnormal bone marrow signal were attributed to technical malfunction of the MRI coil or scanner. After troubleshooting sources of malfunction, a repeated MRI of the foot was obtained and again demonstrated the same bone marrow signal abnormalities; at this time, SABM was diagnosed. Knowledge of this condition can prevent the misinterpretation of SABM on MRI and prevent the waste of time and medical resources.

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通过磁共振成像诊断的足部骨髓浆液性萎缩:病例报告。
骨髓浆液性萎缩(SABM)的特点是骨髓元素被细胞外胶状物质局灶性取代。它与多种慢性疾病有关,包括神经性厌食症、恶性肿瘤、慢性肾病和某些慢性感染。以往的文献报道这种疾病主要通过骨髓活检确诊,并且发生在四肢远端以外的部位。在此,我们描述了一例通过磁共振成像(MRI)诊断的发生在足部的 SABM,这种现象很少见报道。患者是一名 45 岁的女性,患有终末期肾病、充血性心力衰竭、2 型糖尿病和外周动脉疾病,最初表现为双侧足部溃疡不愈合。由于足部持续感染和伤口愈合不良,她随后接受了几次足科手术。在她最近一次住院期间,医生对她的双脚进行了核磁共振成像检查,发现骨髓信号异常,原因是核磁共振成像线圈或扫描仪出现技术故障。在排除故障原因后,再次进行了脚部核磁共振成像,结果再次出现相同的骨髓信号异常;此时,SABM 被确诊。了解这种情况可以避免在核磁共振成像中误诊为 SABM,避免浪费时间和医疗资源。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
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