PMC8462867_01
A. Axial  diffusion weighted  image (DWI): Multiple foci of restricted diffusion including a dominant peri-centimeter region in the right splenium of the corpus callosum(see arrow); B. Axial T2/FLAIR at the level of the centrum semiovale:  Hyperintense foci indicative of vasogenic edema in the bilateral white matter including deep and subcortical aspects (encircled in white). Incidental bilateral cerebral convexity subdural collection that are hyperintense in signal (and intermediate intensity on T1) favoring chronic subdural hematomas (encircled in red); C. Axial susceptibility weighted image (SWI) at the level of the cerebellum: Numerous hypointense foci indicative of microhemorrhages throughout the cerebellum and brain stem
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A second MRI brain obtained on day 7 revealed multiple scattered microthrombi, bilateral chronic subdural hematomas, diffusion restriction in the splenium of the corpus callosum, and extramedullary hematopoiesis in the calvarium (Figure 1).
Coronal PD MRI of left and right hips without contrast showing serpentine low signal irregularity along the weightbearing portion of the femoral head with associated rim of edema compatible with avascular necrosis. There are extensive regions of bonny infarctions involving the entire visualized bony pelvis (including the pubic body, ischial tuberosity, iliac wing and sacrum) and proximal femur/intertrochanteric region. Both studies are indicatvie of stage 3 and suspected early stage 4 FICAT femoral head avascular necrosis
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In subsequent visits, additional workup showed avascular necrosis of the bilateral hips and left shoulder (indicative of stage III or early stage IV FICAT avascular necrosis, Figures 2 &3).
. MRI left shoulder demonstrating serpiginous PD hyperintense and T1 hypointense signal along the peripheral margin of the humeral head. These fingidngs are consistent with avascular necrosis of the left humeral head
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In subsequent visits, additional workup showed avascular necrosis of the bilateral hips and left shoulder (indicative of stage III or early stage IV FICAT avascular necrosis, Figures 2 &3).