Background: Musculoskeletal manifestations are common in sickle cell disease (SCD). Vasoocclusive crisis can manifest acutely as joint and bone pain, osteomyelitis and/or arthritis. It can also lead to chronic bone aches, bone deformities, degenerative arthritis, pathological fractures, and osteoporosis. Hyperbaric oxygen (HBO) therapy is a mode of treatment in which Case Shier et al.: Short-Term Outcome and MRI Changes in Three Adult Patients with SCD and Aseptic ON after Treatment with HBO Therapy 366the patient is exposed to very high arterial and tissue oxygen pressure, during multiple sessions. It has been used as primary or adjunctive therapy for a variety of medical disorders, including necrotizing infection and sickle cell crisis. Case Report: In this case series, 3 patients with SCD and avascular necrosis were treated with 15-40 sessions of HBO and were assessed 6-12 months by MRI after treatment. They showed different clinical outcomes and MRI changes. Conclusion: We concluded that HBO can result in some subjective improvement, especially in early stages. Further studies on severe cases are needed.

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Introduction:Spinal cord compression secondary to extramedullary hematopoiesis (EMH) is a rare condition. Variable treatment options have been reported with different efficacy and recurrence rate. Due to its rarity, no clear optimal management guidelines have been established yet.Patient concerns and diagnosis:We report a recurrence of spinal cord compression secondary to EMH in a 19-year-old male, with a background of transfusion-dependent beta-thalassemia on luspatercept, who presented with weakness in both lower limbs.Interventions and outcomes:He was treated successfully both times with radiotherapy.Conclusion:Early diagnosis and management of EMH compressing the spinal cord are essential to prevent permanent neurological damage. Diagnosis should be suspected based on the clinical presentation and magnetic resonance imaging findings in a patient with a history of ineffective hemopoiesis. Treatment option remains controversial. Radiotherapy option seems effective, even in recurrent cases, and valid, particularly for those at high risk of surgery or who do not prefer it.

we reported an18 years old male with beta thalassemia major who presented with back pain progressive over 1 month associated with numbness in thighs, together with lower limbs weakness and difficulty walking. he also mentioned having difficulty in passing urine. he received radiotherapy which results in significant improvement in symptoms

Extramedullary hematopoiesis (EMH) is a well‐known complication of beta thalassemia major and frequently occurs in typical sites such as liver or spleen. However, when presenting in unusual sites as sacrum, other diagnosis should be excluded by histopathology prior to deciding on treatment plan.