Beta thalassemia major - Cooley anemia

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Acute knee injury with medial pain. ?medial meniscal injury.

Patient Data

Age: 45 years
Gender: Male

Reversal of normal marrow signal seen as predominantly bright PD fat sat and dark T1 signal, indicating conversion of yellow to red marrow. Exaggerated trabeculae and slight bone expansion.

Haemopoietic expansion results in abnormal high signal intensity marrow on the PD FS and T2 FS sequences. Normal signal in the patella, indicating it contains normal yellow marrow and normal trabeculae.

This lateral radiograph of the lumbar spine was on PACS (no mention of underlying diagnosis in the clinical notes). For a 45-year-old the vertebrae are porotic with prominent vertical trabeculations typical of thalassemia.

Case Discussion

Both the plain film and MRI demonstrate prominence of trabecular striations which is seen in thalassemia. The diagnosis of beta thalassemia was confirmed with the clinician.

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