consult: marrow signal changes

MRI to evaluate cuff tear, shows mild tendinosis and bursitis (not shown).
I found a history of Sarcoidosis as part of the clinical history dictated for prior radiographs.
What do you think these numerous rounded dark T1/Bright PFS marrow foci are?
Sarcoid?
Other?
Would you recommend follow up?
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Hilary

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1 thought on “consult: marrow signal changes”

  1. OCAD

    I didn’t make myself clear.
    I have seen osseous sarcoidosis on MRI.
    It can have a variable appearance, as is clear from Avneesh’s and Uma’s cases.

    Given that she has a history of sarcoidosis, it seems like that these marrow changes are related to her known diagnosis, but I do not believe that this is pathognomonic and there is No differential diagnosis.
    It concerns me that people might actually believe that.

    I have received a few comments from people who say that they have seen Myeloma looks just like this.
    That was helpful.
    My colleague thought that this might be related to red marrow, though I didn’t think the appearance was typical of that.
    I will report the differential considerations, favoring sarcoid and suggesting follow up in 4-6 months to confirm stability, if clinically indicated.

    Thanks to all who commented.

    Hilary

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