Is MRI Necessary for Skeletal Evaluation in Sickle Cell Disease

Sachan, Ankita Arun; Lakhkar, Bhushan N.; Lakhkar, Bhavana; Sachan, Shivam

doi:10.7860/jcdr/2015/12747.6095

Cited by 4 publications

(8 citation statements)

References 8 publications

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“…For this reason, we had to use a classification of AVNs that is based only on observations made at the hip and femoral head. There is no classification for AVNs that considers the entire skeleton, despite the presence, also highlighted in this study, of other segments highly involved 17 …”

Section: Discussionmentioning

confidence: 89%

“…Blood flow is compromised, increasing the risk of multifocal lesions, leading to long‐term disability, chronic pain, and bone fractures. The incidence of AVN increases with age, progressing from initial uniform oedema of bone marrow to areas with frank signals of infarcts or degenerative and sclerotic tissue 15,17 . The head of the femur is mainly involved in this pathological process, and, to the best of our knowledge, very few studies explore other skeletal segments in SCD children 5,21,22 .…”

Section: Discussionmentioning

confidence: 99%

“…Hands, feet, forearms, and distal legs were excluded to avoid long acquisition sessions. All abnormal MRI findings were considered in the study: the diagnosis of lesions ranged from areas of diffuse hyperintense signal described as uniform edema to abnormal band‐like signals and hypo‐intense band‐like zones on T1‐weighted images, which match hyper‐intense zones STIR images according to the classification of bone infarcts and lesions described elsewhere 12,15–18 …”

Section: Methodsmentioning

confidence: 99%

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Occult ischemic bone lesions in children with sickle cell disease: A study of prevalence

Voi

Turrini

Mattavelli

et al. 2022

European J of Haematology

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Introduction Avascular necrosis (AVN) is a severe complication of sickle cell disease (SCD) and involves principally the femoral head. Few data exist about the prevalence of lesions in other segments. Methods In this cross‐sectional study, 42 children (20 males and 22 females) underwent a magnetic resonance imaging (MRI) of the spine, upper arms, and femurs. The primary outcome was to define the prevalence and locations of bone infarcts. Results Forty‐two patients completed the study; the total median age was 11.9 years (interquartile range = 9.5–13.9). Eleven patients (26.2%) were positive for altered bone findings for a total of 32 lesions. Most of the lesions were in the humerus 17 (53.1%), 11 (34.4%) in the femurs, and 4 (12.5%) in the vertebrae. The median number of vaso‐occlusive crises (VOCs) was two and four for patients without and with bone lesions, respectively (p = .01). The annual rate of VOC is the best marker for the positive MRI (odds ratio = 82.6; p = .03), and it is correlated with the number of sites involved (p = .02). Conclusions Our study highlights that the prevalence of skeletal lesions could be underestimated, and it provides the basis for clinical reasoning and tailored therapy in SCD children.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Occult ischemic bone lesions in children with sickle cell disease: A study of prevalence

Voi

Turrini

Mattavelli

et al. 2022

European J of Haematology

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“…al. studies correlation between nephropathy and ophthalmic complications in cases of sickle cell anemia [16]. Related studies were reported by Karthik et al [17], Sachan et al [18] and Verghese et al [19]. Wasnik et al reported a study on evaluation of serum zinc and antioxidant vitamins in adolescent homozygous sickle cell patients in Wardha [20].…”

Section: Discussionmentioning

confidence: 98%

Clinical Outcome and Laboratory Parameters in Sickle Cell Anemia Patients of Pediatric Age Group Post Hydroxyurea Therapy

Gupta

Hiwale

Vagha

et al. 2021

JPRI

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Background: Homozygous condition in Sickle cell disease (SCD) is called as sickle cell anemia(SCA). In sickle cell anemia patients clinically presents as hemolytic anemia, vaso-occlusive events, along with organ dysfunction and acute chest syndrome. Recently Hydroxyurea has shown promising results in treatment of sickle cell anemia. Hydroxyurea is the only approved drug by FDA which has shown disease modifying results. Aim: To determine the clinical outcome and laboratory parameters in SCA patients of pediatric age group post-hydroxyurea therapy. Methods: A total of 30 patients who were diagnosed as Sickle cell anemia (SCA) patients in Sickle cell anemia OPD of Pediatric department were included in the study. Results: Hydroxyurea therapy is expected to increase HbF% levels and improve the clinical outcome and laboratory parameters in sickle cell anemia patients of pediatric age group.

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“…Previous studies have evaluated osteoarticular involvement in patients with SCD in the acute phase. However, our study evaluated lesions in patients on a steady-state fasis, which explains the low incidence of infectious and inflammatory changes, which were highly prevalent in past studies [17][18][19], and a high incidence of OA and ON. The main sites of bone involvement were the spine, followed by the femur and the shoulders and the most frequent changes were ON, followed by OA, as classically described [6].…”

Section: Discussionmentioning

confidence: 99%

Chronic osteo-articular changes in patients with sickle cell disease

et al. 2021

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Background Sickle cell disease (SCD) is an autosomal recessive genetic disease in which a mutation occurs in the β-globin chain gene, resulting in abnormal hemoglobin levels. In an environment with reduced oxygen concentration, red blood cells change their conformation, resulting in chronic hemolysis and consequent anemia and vaso-occlusive crises with injuries to several organs, with a significant impairment of the osteoarticular system. This study aimed to verify the chronic osteoarticular alterations and their association with clinical and laboratory characteristics of patients with SCD with a more severe phenotype (SS and Sβ0), on a steady-state fasis. Methods Fifty-five patients were referred to a medical consultation with a specialized assessment of the locomotor system, followed by laboratory tests and radiographic examinations. Results In total, 74.5% patients had hemoglobinopathy SS; 67.3% were female; and 78.2% were non-whites. The mean patient age was 30.5 years. Most patients (61.8%) reported up to three crises per year, with a predominance of high-intensity pain (65.5%). Radiographic alterations were present in 80% patients. A total of 140 lesions were identified, most which were located in the spine, femur, and shoulders. Most lesions were osteonecrosis and osteoarthritis and were statistically associated with the non-use of hydroxyurea. Conclusions There was a high prevalence of chronic osteoarticular alterations, which was statistically associated only with the non-regular use of hydroxyurea.

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Is MRI Necessary for Skeletal Evaluation in Sickle Cell Disease

Cited by 4 publications

References 8 publications

Occult ischemic bone lesions in children with sickle cell disease: A study of prevalence

Occult ischemic bone lesions in children with sickle cell disease: A study of prevalence

Clinical Outcome and Laboratory Parameters in Sickle Cell Anemia Patients of Pediatric Age Group Post Hydroxyurea Therapy

Chronic osteo-articular changes in patients with sickle cell disease

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