Characteristic MR Imaging Findings of the Temporomandibular Joint in Diabetes Mellitus: Focus on Abnormal Bone Marrow Signal of the Mandibular Condyle and Lymph Node Swelling in the Parotid Glands

Purpose. The increased use of magnetic resonance imaging (MRI) has resulted in reports of incidental abnormal bone marrow (BM) signal. Our goal was to determine the evaluation of an incidental abnormal BM signal on MRI and the prevalence of a subsequent oncologic diagnosis.Methods. We conducted a retrospective cohort study of patients over age 18 undergoing MRI between May 2005 and October 2010 at Tufts Medical Center (TMC) with follow-up through November 2013. The electronic medical record was queried to determine imaging site, reason for scan, evaluation following radiology report, and final diagnosis.Results. 49,678 MRIs were done with 110 patients meeting inclusion criteria. Twenty two percent underwent some evaluation, most commonly a complete blood count, serum protein electrophoresis, or bone scan. With median follow-up of 41 months, 6% of patients were diagnosed with malignancies including multiple myeloma, non-Hodgkins lymphoma, metastatic non-small cell lung cancer, and metastatic adenocarcinoma. One patient who had not undergone evaluation developed breast cancer 24 months after the MRI.Conclusions. Incidentally noted abnormal or heterogeneous bone marrow signal on MRI was not inconsequential and should prompt further evaluation.

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Involvement of the proximal tibiofibular joint in ankylosing spondylitis

Acta Radiologica ◽

10.1080/02841850902783338 ◽

2009 ◽

Vol 50 (4) ◽

pp. 418-422 ◽

Cited By ~ 3

Author(s):

Hyun Pyo Hong ◽

Hye Won Chung ◽

Byeong-Kyoo Choi ◽

Young Cheol Yoon ◽

Sang Hee Choi

Keyword(s):

Bone Marrow ◽

Lumbar Spine ◽

Ankylosing Spondylitis ◽

Signal Intensity ◽

Proximal Tibiofibular Joint ◽

Plain Radiographs ◽

Bone Marrow Signal ◽

Abnormal Bone Marrow ◽

Marrow Signal ◽

Subchondral Sclerosis

Background: Ankylosing spondylitis (AS) may affect peripheral joints, with the shoulder, hip, and knee being well known involved sites. However, involvement of the proximal tibiofibular (PTF) joint has not yet been investigated. Purpose: To evaluate PTF joint abnormalities in patients with AS. Material and Methods: From July 1997 to June 2005, 16 patients (15 male, one female; mean age 25 years), who were clinically diagnosed with AS, underwent magnetic resonance imaging (MRI) to evaluate knee pain. All patients also underwent plain radiographs of the knee, lumbar spine, and pelvis. Twenty knee MRIs (bilateral in four patients) and 16 sets of knee, lumbar spine, and pelvic radiographs were retrospectively reviewed in order to evaluate possible AS involvement. The presence of abnormalities suggesting AS involvement were recorded separately in the sacroiliac joints, lumbar spine, hip, and femorotibial and PTF joints. If the PTF joint showed any pathologic findings, the radiologic findings were recorded. Results: Three of 16 patients (18.7%) had pathologic features of the PTF joint observed by plain radiographs or MRI. One of these three patients showed bilateral involvement of the PTF joints on plain radiographs, while the other two patients showed unilateral involvement on MRI. Subchondral sclerosis, cartilage abnormality, erosion, and abnormal bone marrow signal intensity were identified on MRI. Plain radiographs of two patients revealed subchondral sclerosis and spur formation in the PTF joint. The frequencies of involvement of other joints in the 16 patients were as follows: lumbar spine, n=5 (31%), hip joint, n=1 (6%) (identified by plain radiographs), and femorotibial joints, n=10 (62.5%) (identified by knee MRI). Conclusion: MR imaging of the PTF joint can depict synovial changes and their effect on joint structures in patients with AS. The MRI findings of AS involving the PTF joints are subchondral sclerosis, cartilage abnormality, erosion, and abnormal bone marrow signal intensity.

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Diagnostic Effectiveness of Gadolinium-enhanced MR Imaging in Evaluation of Abnormal Bone Marrow Signal

Radiology ◽

10.1148/radiol.2242020479 ◽

2002 ◽

Vol 224 (2) ◽

pp. 320-322 ◽

Cited By ~ 14

Author(s):

Timothy J. Mosher

Keyword(s):

Bone Marrow ◽

Mr Imaging ◽

Bone Marrow Signal ◽

Abnormal Bone Marrow ◽

Marrow Signal

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Abnormal bone marrow signal on MRI heralding oncologic diagnoses: A single institution review.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.1580 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 1580-1580

Author(s):

Gunjan L. Shah ◽

Jamie Michelle Bunch Jarboe ◽

Aaron Seth Rosenberg ◽

Andreas Kirschmer Klein ◽

Furha Iram Cossor

Keyword(s):

Bone Marrow ◽

Medical Center ◽

Final Diagnosis ◽

Peripheral Blood Flow ◽

Bone Marrow Signal ◽

Radiology Reports ◽

Abnormal Bone Marrow ◽

Magnetic Resonance Imaging Mri ◽

Marrow Signal

1580 Background: The increased use of magnetic resonance imaging (MRI) has resulted in increased numbers of incidental findings. Oncologists often receive consults for workup of "abnormal marrow signal." As there is no standard evaluation for such findings and the yield of additional evaluation is unclear, we performed a retrospective study of patients evaluated with MRI at Tufts Medical Center (TMC). Methods: With IRB approval, TMC radiology reports were searched from 5/9/05-12/31/08 with GE Centricity Radiology Information System 2.2. Included patients had MRI reports containing the phrases “abnormal bone marrow” or “heterogeneous bone marrow”, but no clear etiology stated. Further workup, including referral to a subspecialist, laboratory, radiographic, or pathologic evaluations, final diagnosis, and last follow up were collected. Results: 29,508 MRIs were performed and 77 patients met search criteria. Median age was 58 years with a median follow-up of 41 months at TMC after qualifying MRI. 40/77 (52%) of patients had either an MRI of the lumbar spine or hip with 21/77 (27%) undergoing work-up for the marrow findings. Evaluations included CBC (38%), SPEP (24%), quantitative immunoglobulins (14%), free light chains (10%), peripheral blood flow cytometry (5%), bone marrow biopsy (19%), skeletal survey (14%), bone scan (48%), CT scan (24%), biopsy of other site (24%), and subspecialty referal (48%, 29% to oncology). Definitive diagnosis was assigned in 11/21 (52%) cases, with 5 being malignancies (1 follicular lymphoma, 2 multiple myeloma, 2 lung cancer). Three patients were later diagnosed with malignancy (breast cancer, myelodysplastic syndrome, merkel cell carcinoma) at a median of 19 months. Overall, 10% of patients with abnormal marrow on MRI were diagnosed with a malignancy. Conclusions: Incidentally noted abnormal or heterogeneous bone marrow signal on MRI was not inconsequential. Of those patients who underwent evaluation for the finding, 24% were diagnosed with a malignancy. We conclude that abnormal bone marrow findings on MRI should not be ignored, and given the rates of malignancy in our series, oncologists are ideally suited for this task.

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Incidental enchondromas at knee magnetic resonance imaging: intraobserver and interobserver agreement and prevalence of imaging findings

Radiologia Brasileira ◽

10.1590/s0100-39842013000300004 ◽

2013 ◽

Vol 46 (3) ◽

pp. 129-133 ◽

Cited By ~ 8

Author(s):

Sandra Akemi Nakamura ◽

Mário Müller Lorenzato ◽

Edgard Eduard Engel ◽

Maurício Eiji de Almeida Santos Yamashita ◽

Marcello Henrique Nogueira-Barbosa

Keyword(s):

Magnetic Resonance Imaging ◽

Bone Marrow ◽

Magnetic Resonance ◽

Interobserver Agreement ◽

Magnetic Resonance Images ◽

Imaging Findings ◽

Resonance Imaging ◽

Bone Marrow Signal ◽

Marrow Signal ◽

Knee Magnetic Resonance Imaging

Objective To evaluate intra- and interobserver agreement in the identification of incidental enchondromas at knee magnetic resonance imaging, and to assess the prevalence of imaging findings. Materials and Methods Retrospective study reviewing 326 knee magnetic resonance images acquired in the period between November 2009 and September 2010. The images were independently and blindly analyzed by two specialists in musculoskeletal radiology, with the objective of identifying incidental enchondromas, presence of foci with signal similar to bone marrow and foci of signal absence suggestive of calcifications within the enchondromas. Inter- and intraobserver agreements were analyzed. Results Eleven lesions compatible with enchondromas (3.3%) were identified. The interobserver agreement for the presence of enchondroma was high. Prevalence of foci of bone marrow signal inside the enchondromas was of 54.55%, and foci suggestive of calcification corresponded to 36.36%. The intraobserver agreement for foci of bone marrow signal in enchondromas was perfect, and interobserver agreement was high. Conclusion The prevalence of incidental enchondromas in the current study was compatible with data in the literature. Excellent agreement was observed in the identification of enchondromas and in the assessment of imaging findings. A higher prevalence of fat signal foci was observed as compared with signal absence suggestive of calcifications.

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