Abnormal Bone Marrow Signal Intensity in the Phalanges of the Foot as a Manifestation of Raynaud Phenomenon: A Report of Six Patients

Smitaman, Edward; Pereira, Bruno P. G.; Huang, Brady K.; Zakhary, Mina M.; Fliszar, Evelyne; Resnick, Donald

doi:10.2214/ajr.16.16366

Cited by 11 publications

(23 citation statements)

References 22 publications

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“…is can be associated with an abnormal marrow oedema-like signal limited to the distal phalanges of the hands or feet [13]. Similar changes have also been observed in patients with critical limb ischemia.…”

Section: Vasculopathysupporting

confidence: 53%

Radiologic Mimics of Osteomyelitis and Septic Arthritis: A Pictorial Essay

Lim

Barras

Zadow

2021

Radiology Research and Practice

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Various imaging techniques may be employed in the investigation of suspected bone and joint infections. These include ultrasound, radiography, functional imaging such as positron emission tomography (PET) and nuclear scintigraphy, and cross-sectional imaging, including computed tomography (CT) and magnetic resonance imaging (MRI). The cross-sectional modalities represent the imaging workhorse in routine practice. The role of imaging also extends to include assessment of the anatomical extent of infection, potentially associated complications, and treatment response. The imaging appearances of bone and joint infections are heterogeneous and depend on the duration of infection, an individual patient’s immune status, and virulence of culprit organisms. To add to the complexity of radiodiagnosis, one of the pitfalls of imaging musculoskeletal infection is the presence of other conditions that can share overlapping imaging features. This includes osteoarthritis, vasculopathy, inflammatory, and even neoplastic processes. Different pathologies may also coexist, for example, diabetic neuropathy and osteomyelitis. This pictorial review aims to highlight potential mimics of osteomyelitis and septic arthritis that are regularly encountered, with emphasis on specific imaging features that may aid the radiologist and clinician in distinguishing an infective from a noninfective aetiology.

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Section: Vasculopathysupporting

confidence: 53%

Radiologic Mimics of Osteomyelitis and Septic Arthritis: A Pictorial Essay

Lim

Barras

Zadow

2021

Radiology Research and Practice

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“…Smitaman et al described identical MRI findings where an observational cohort of 6 patients with RP demonstrated pedal phalangeal bone marrow edema [9]. Signal abnormalities in their study were most evident in the first through fourth toes and displayed a progressive distal-to-proximal distribution between patients.…”

Section: Discussionmentioning

confidence: 64%

“…Given that RP is predominantly a clinical diagnosis, there is limited literature discussion of the imaging findings [9]. Additionally, there is no literature that provides follow-up imaging of the progression or resolution of RP involving the pedal distal phalanges.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, there is no literature that provides follow-up imaging of the progression or resolution of RP involving the pedal distal phalanges. While radiologic modalities such as conventional angiography, magnetic resonance angiography, Doppler imaging, infrared thermography, and digital blood flow scintigraphy have supported the diagnosis, phalangeal bone marrow edema on magnetic resonance imaging (MRI) has also been observed in a small subset of patients [9], [10], [11], [12], [13], [14], [15]. As most cases lack radiologic correlation to the clinical diagnosis of RP, the purpose of this case report is to describe the progressive abnormal pedal distal phalanges MRI findings in a patient with known RP.…”

Section: Introductionmentioning

confidence: 99%

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Raynaud's phenomenon manifesting as progressive abnormal MRI bone marrow signal in the toes

Brown

Handley

Simon

2019

Radiology Case Reports

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Objective The purpose of this report is to discuss the presentation and the progressive magnetic resonance imaging (MRI) findings in a single patient with clinically-diagnosed Raynaud's phenomenon (RP). Conclusion RP can present as non-specific toe pain and manifest as progressive abnormal MRI bone marrow signal in the toes. In addition to patient presentation and clinical assessment, this information could contribute to earlier diagnosis and treatment of RP and other coexisting rheumatologic disorders.

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“…The MRI features of Raynaud's phenomenon have not been well documented in the literature; however, there are articles which characterise the phalanges of the feet. 2,3 The prominent feature of Raynaud's phenomenon documented on MRI included abnormal bone marrow signal on two or more phalanges. Involvement of the distal phalanges was most common, with involvement of the middle and then proximal phalanges.…”

Section: Discussionmentioning

confidence: 99%