PMC3420544_01
MRI of the spine at the disease presentation. Multiple vertebrae lesions are demonstrated in the cervical, thoracic, and lumbar spine, which exhibit increased signal intensity on sagittal T2-weighted images (a), (b), and (c). The appearance of the intervertebral discs is normal.
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Despite magnetic resonance imaging (MRI) showing characteristic lesions (Figure 1), the diagnosis of CRMO was not considered, and the patient was hospitalized on several occasions for diagnostic investigation.
MRI and US of the left knee at the disease presentation. T2-weighted sagittal image (a) and US (b) demonstrated synovial thickening with increased vascularity (b) and joint effusion. The signal intensity of the distal femur and proximal tibia is normal (a), (c).
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MRI demonstrated synovitis and joint effusion in both knees, most prominent in the left (Figure 2). MRI of the knees did not detect bone lesions in the distal femur or the proximal tibia (Figures 2(a), 2(c)).
Bone scan at the disease presentation. Since the radiological investigation for bone lesions in this area proved negative, the increased uptake in both knees (a) was attributed to synovitis. Increased uptake was also demonstrated in the sternum (manubrium and body synchondrosis) (b), in thoracic vertebrae (c), and in the left hip (d).
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Bone scan showed increased uptake mainly in both knees, in thoracic vertebrae (T5, T6), in the left hip, and in the manubrium and body of the sternum (Figure 3).
MRI of the spine one year from the disease presentation.
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She was in good general condition, the spinal MRI showed significant amelioration of bone lesions most of which had completely disappeared (Figure 4), and the US examination of both knees did not reveal findings of arthritis.