Sickle cell-related bone marrow complications: the utility of diffusion-weighted magnetic resonance imaging

Systemic Changes Affecting the Morphology of Calvarial Bone

Plastic surgeons are frequently consulted to evaluate concerns about a patient's skull. Imaging studies often reveal abnormalities in bone morphology, from increased porosity to sclerotic changes. While focal findings imply a benign or malignant neoplasm, the etiology of more diffuse findings can be more varied, making the correct diagnosis challenging. The present review summarizes the differential diagnosis of osseous lesions of the calvarium that affect the bone and contribute to changes seen on imaging studies.

Whole-body magnetic resonance imaging: techniques and non-oncologic indications

Whole-body MRI is increasingly utilized for assessing oncologic and non-oncologic diseases in infants, children and adolescents. Focusing on the non-oncologic indications, this review covers technical elements required to perform whole-body MRI, the advantages and limitations of the technique, and protocol modifications tailored to specific indications. Rheumatologic diseases account for the majority of non-oncologic whole-body MRI performed in pediatric patients at the author's institution. Whole-body MRI helps in establishing the diagnosis, documenting disease extent and severity, and monitoring treatment response in enthesitis-related arthritis (ERA) and chronic recurrent multifocal osteomyelitis (CRMO). Other non-oncologic indications for whole-body MRI include osteomyelitis (usually pyogenic), pyrexia of unknown origin, neuromuscular disorders, inherited and inflammatory myopathies such as juvenile dermatomyositis and polymyositis, avascular necrosis, and fat/storage disorders. Use of whole-body MRI in postmortem imaging is rising, while whole-body MRI in non-accidental injury is considered to be of limited value. Imaging findings for a range of these indications are reviewed with whole-body MRI examples.

Back pain: the sole of presentation of sickle cell disease

Diagnosing back pain in children and adolescents can be a challenge to health care providers. Although studies show that more than half of the cases of back pain in children are of non-organic cause, missing the right diagnosis could be detrimental. We present a case of lower back pain in a ten-year-old male whom we eventually diagnosed with hemoglobin SE mutation, which responded well to pain management. Hence, sickle cell disease with vaso-occlusive crisis should be incorporated into the list of differential diagnoses in children with back pain.