Follow-up MRI after 12 months of fortnightly intravenous enzyme replacement therapy
Lumbar Spine : Marrow signal in the lumbar spine is now within normal limits. Degenerative Modic type 1 changes on either side of the L5/S1 disc are unchanged. No abnormal T2 signal elsewhere and no evidence of infarction.
Femur : Signal has improved through both femora since the previous examination, although a mild homogeneous pattern of marrow infiltration persists throughout including the proximal and distal epiphyses. Tiny diaphyseal medullary infarcts are seen on the left. In the distal metaphysis on both sides there is oedema signal which does suggest developing infarcts. T2 signal in the femoral diaphyses has largely resolved.
Conclusion : Resolution of changes in the lumbar spine. Improvement in the femora except in the distal femoral metaphyses were there is a new bone marrow oedema pattern, raising the possibility of developing infarcts.
Lumbar bone marrow burden score 0, femoral bone marrow burden score 5