Radiological changes in elderly patients with sickle cell anaemia

ABSTRACT

The survival of a relatively large group of patients with SS disease beyond the age of 40 years in Jamaica has enabled a number of studies defining the charcteristics of this group. These are important because this group may reflect extremes of pathological change consequent on the long duration of the sickling process. The present paper describes the pattern of bone involvement in patients over the age of 40 years as detected by skeletal surveys of the skull, lumbar spine, pelvis, shoulders, hands, femurs, tibia, fibulae and chest. Radiologial evidence of bone marrow expansion was common and included widening of the marrow cavities, large nutrient foramino, osteoporosis, and coarsencing of the remaining trabecular pattern. Calcified medullary infarction in long bones, which has been considered rare in SS disease, was common in this group. Changes consistent with avascular necrosis of the femoral and humeral heads occurred and were often unsuspected clinically, especially with humeral involvement. Factors leading to these changes are discussed (AU)