Presentation
The patient, with a BMI of 15.5 (body mass index), fell on their own and fractured the right iliac bone.
Patient Data
The high signal intensity of bone marrow and subcutaneous compartments will be found on fat-suppressed fluid-sensitive sequences (T2 fat sat and STIR). Intermediate to low bone marrow and soft tissue signals will be seen on T1-weighted images.
Case Discussion
Patient has underlying osteoporosis with severe bone marrow atrophy, the MRI images show different signal appearance of the skeletal system and subcutaneous tissues.
The STIR sequence, designed to suppress signal from fat, also enhances the signal from tissue with long T1 and T2 relaxation times. In these cases, it will look like a T1-weighted image. The actual T1 will show a low signal on fat, bone marrow and soft tissue.
The "flip-flop" type of imaging leads at first to confusing signal on MRI, and some extra time with the patient in the magnet, so you could be sure all sequences were properly done.
These findings have been mainly described in cases of bone marrow atrophy.
Other related causes:
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