Hello OCADers,
This case came through yesterday afternoon so I thought I’d resurrect this thread. 65 yo M with shoulder pain, no additional helpful history. Interestingly, osteopoikilosis was suggested on a recent shoulder x-ray from an outside facility so evidently there are sclerotic foci to correspond with the changes on MRI. Unfortunately, I don’t have access to the x-ray. Perhaps not appreciable here, but some of the foci appear curvilinear and branching. It does appear quite similar to Hilary’s original case. I led with venolymphatic anomaly but gave a broad ddx, and the patient is being referred to heme-onc for further w/u.
Any pertinent thoughts would be appreciated!
clockwise from upper left
top image: pd ax fatsat, t1 post gad ax fatsat, pd cor fatsat, T1 cor.
bottom image: pd sag fatsat, T1 sag, T1 post gad cor fatsat, T2 cor.
On Thu, Jan 11, 2024 at 1:28 PM Emi Marinela wrote:
I am extremely happy to be a part of this group and want to thank everyone for sharing their interesting cases and thoughts.
In accordance with discussions held in the last few days, just this week, I examined a F, 50 years old, with acute myeloid leukemia diagnosed in the last quarter of last year, with chemotherapy started in October 2023, who complains of pain in the left shoulder.
Apart to rotator cuff tendinopathies, please help me classify bone structure changes. It seems to me that I distinguish intraosseous, gadophilic vascular pathways, but I think that is not all. Your opinions would help me a lot.I wish you all, a more than perfect 2024!
În lun., 8 ian. 2024 la 20:01, hilary a scris:
Cor T1 and PDFS Sag PDFS
This doesn’t look like Grandma’s osteoporosis.
What is going on here????There is a large parafoveal chondral defect, a small effusion and labral tear…but no fracture….I’m only inquiring about the marrow signal abnormality.
Thanks.
Hilary
