MRI findings of serous atrophy of bone marrow and associated complications

Abstract

• SABM occurs in several underlying conditions, most commonly anorexia nervosa and cachexia. • Abnormal marrow signal is often misinterpreted as technical error requiring unnecessary repeat imaging. • SABM is frequently associated with stress fractures. • Fractures in SABM can be obscured by marrow signal abnormality on MRI.

Chronic hip pain

“…It occurs in a wide range of underlying conditions including anorexia nervosa, malabsorption (celiac disease or inflammatory bowel disease), massive weight loss after bariatric surgery, alcoholism, advanced cancers, and chronic infections such as acquired immunodeficiency syndrome (AIDS) [1][2][3]. GMT was first identified in autopsy specimens of patients suffering from starvation which led to the alternative term Bbone marrow starvation^ [2,[4][5][6].…”

“…GMT was first identified in autopsy specimens of patients suffering from starvation which led to the alternative term Bbone marrow starvation^ [2,[4][5][6]. Histologically, GMT is characterized by hypoplasia of hematopoietic cells, fatty atrophy, and deposition of a gelatin-like substance rich in hyaluronic acid [1,2,5]. The pathophysiology of GMT is not well understood.…”

“…Laboratory studies often show pancytopenia or isolated cytopenias such as anemia or leukopenia [8,9]. Patients are at increased risk for infection [1]. GMT is also associated with bone fragility and increased risk of stress fractures [1].…”

“…Patients are at increased risk for infection [1]. GMT is also associated with bone fragility and increased risk of stress fractures [1].…”

“…MRI commonly leads to diagnosis of GMT before it is considered clinically [1]. The predominate MRI findings are hypointense bone marrow signal on T1-weighted imaging and hyperintense bone marrow signal on fat-suppressed fluid-sensitive imaging, or essentially reversal of normal T1 and T2 bone signal intensity [1].…”