Presentation
Nephrotic syndrome with both leg and ankle pain, and inability to walk.
Patient Data
There are irregular, serpiginous abnormal signal lines observed within the medullary space of the distal extremity of the tibia, calcaneus, and talus bilaterally. On PD images, there is a hyperintense line paralleling the inner surface of the hypointense line within the marrow.
Case Discussion
Medullary bone infarcts and avascular necrosis are common complications of aggressive or long-term steroid therapy. Diseases such as nephrotic syndrome are commonly treated with corticosteroids, and the clinician and radiologist must be aware in their evaluation for these complications.