Manifestations osseuses des anémies de l'enfant

Radiological signs are important aspects of anemia in children, malignant diseases being excluded. Among these signs, osseous manifestations may be a diagnostic clue in haemoglobin disorders such as sickle-cell disease or thalassemia. In both, medullar expansion may be observed, with cortical thinning related to medullar hyperplasia. In case of homozygoteous thalassemia, extra-medullar haematopoiesis mainly in the mediastinum can be also observed. In sickle-cell disease the images are partly related to medullar hyperplasia but also to thrombosis and bone infarcts. The location of these signs follows the process of conversion from red marrow to fatty marrow. So it will start at the extremities to involve in adolescents the spine and the proximal epiphysis of the limbs. The main complication is a superimposed infection of the infarcted areas. The differential diagnosis between infection and pure necrosis is very difficult in such patients.