Multiple bone infarcts

Case contributed by Utkarsh Kabra
Diagnosis almost certain

Presentation

Known case of CML presenting with bilateral knee pain (left>right).

Patient Data

Age: 25 years
Gender: Female

Left knee

mri

Multiple bone infarcts in are seen distal femur (involving both femoral condyles and anterior intercondylar region), proximal tibia (involving both tibial condyles) and in patella. Surrounding marrow edema is seen in medial aspect of distal femur and in patella.

Double-line sign is seen on T2 images with hyperintense inner ring of granulation tissue and a hypointense outer ring of sclerosis.

Mild marrow edema is seen in proximal fibula.

Full thickness fissuring of articular cartilage is seen along medial articular facet of patella.

Right knee

mri

Similar findings are seen in contralateral knee.

Case Discussion

Multiple bone infarcts in bones involving both knees as described. Bone infarcts are characterized by double-line sign on T2 images with hyperintense inner ring of granulation tissue and a hypointense outer ring of sclerosis.

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