BONE-MARROW INFARCTION IN SICKLE-CELL-ANEMIA - CORRELATION WITH HEMATOLOGIC PROFILES

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  • 1 January 1982
    • journal article
    • research article
    • Vol. 60  (6) , 1411-1419
Abstract
Bone marrow infarction was investigated by 99mTc-sulfur colloid imaging in 42 patients with sickle cell anemia (SS) over 2 yr. Marrow defects were demonstrated in 28 patients (66.6%); in 15 (aged 19-52 yr) they were matched by roentgenographic evidence of medullary bone infarction. Repeated images showed no change in the size or site of these defects. Among 13 patients (aged 6-32 yr), all in crisis when initially examined, marrow defects were not associated with roentgenographic changes, and in many cases repeated images showed resolution or decrease in size of the defects in 3-6 mo., even if the limb was swollen and the marrow defect large. Among 14 patients (aged 18-36 yr), all symptomatic at the time of study, no defects were found. Comparison of hematologic variables revealed a higher mean Hb and hematocrit level among those with marrow infarcts (P < 0.001). High levels of HbF or the presence of .alpha.-thalassemia did not protect against marrow infarction. Pulmonary fat embolism was not observed. 99mTc-sulfur colloid marrow imaging was considered to provide more useful information in the initial management of bone pain and swelling in sickle cell crisis than either roentgenographs or conventional 99mTc-methyldiphosphate bone images.