Skip to main content
Top
Published in: Skeletal Radiology 9/2014

01-09-2014 | Case Report

Spinal bone marrow necrosis with vertebral compression fracture: differentiation of BMN from AVN

Authors: J. S. Nix, R. T. Fitzgerald, R. S. Samant, M. Harrison, E. J. Angtuaco

Published in: Skeletal Radiology | Issue 9/2014

Login to get access

Abstract

Bone marrow necrosis (BMN) is a rare malignancy-associated hematologic disorder characterized by necrosis of myeloid and stromal marrow elements with preservation of cortical bone. Overlap between the imaging appearances of BMN and avascular necrosis (AVN) raises the potential for diagnostic confusion. We report a case of BMN presenting with a traumatic multi-level vertebral body collapse, and finding that may potentially confound distinction between the two entities. We discuss important pathophysiologic, clinical, and radiologic differences between BMN and AVN with emphasis on features important in the differential diagnosis.
Literature
1.
go back to reference Tang YM, Jeavons S, Stuckey S, Middleton H, Gill D. MRI features of bone marrow necrosis. Am J Roentgenol. 2007;188:509–14.CrossRef Tang YM, Jeavons S, Stuckey S, Middleton H, Gill D. MRI features of bone marrow necrosis. Am J Roentgenol. 2007;188:509–14.CrossRef
3.
go back to reference Maheshwari PR, Nagar AM, Prasad SS, Shah JR, Patkar DP. Avascular necrosis of spine: a rare appearance. Spine. 2004;29:E119–22.PubMedCrossRef Maheshwari PR, Nagar AM, Prasad SS, Shah JR, Patkar DP. Avascular necrosis of spine: a rare appearance. Spine. 2004;29:E119–22.PubMedCrossRef
4.
go back to reference Javier R-M, Moser T, Dietemann J-L, Sparsa L, Natarajan-Ame S, Chenard M-P, et al. Multiple vertebral osteonecrosis. Joint Bone Spine. 2008;75:341–4.PubMedCrossRef Javier R-M, Moser T, Dietemann J-L, Sparsa L, Natarajan-Ame S, Chenard M-P, et al. Multiple vertebral osteonecrosis. Joint Bone Spine. 2008;75:341–4.PubMedCrossRef
5.
go back to reference Osuorji I, Goldman L. G-CSF-associated bone marrow necrosis in AML after induction chemotherapy. Case Rep Hematol. 2012;2012:1–3.CrossRef Osuorji I, Goldman L. G-CSF-associated bone marrow necrosis in AML after induction chemotherapy. Case Rep Hematol. 2012;2012:1–3.CrossRef
6.
go back to reference Rossi D, Ramponi A, Franceschetti S, Stratta P, Gaidano G. Bone marrow necrosis complicating post-transplant lymphoproliferative disorder: resolution with rituximab. Leuk Res. 2008;32:829–34.PubMedCrossRef Rossi D, Ramponi A, Franceschetti S, Stratta P, Gaidano G. Bone marrow necrosis complicating post-transplant lymphoproliferative disorder: resolution with rituximab. Leuk Res. 2008;32:829–34.PubMedCrossRef
7.
go back to reference Paydas S, Ergin M, Baslamisli F, Yavuz S, Zorludemir S, Sahin B, et al. Bone marrow necrosis: clinicopathologic analysis of 20 cases and review of the literature. Am J Hematol. 2002;70:300–5.PubMedCrossRef Paydas S, Ergin M, Baslamisli F, Yavuz S, Zorludemir S, Sahin B, et al. Bone marrow necrosis: clinicopathologic analysis of 20 cases and review of the literature. Am J Hematol. 2002;70:300–5.PubMedCrossRef
8.
go back to reference Bhasin TS. A case of bone marrow necrosis of an idiopathic aetiology: the report of a rare entity with review of the literature. J Clin Diagn Res. 2013;7(3):525–8.PubMedCentralPubMed Bhasin TS. A case of bone marrow necrosis of an idiopathic aetiology: the report of a rare entity with review of the literature. J Clin Diagn Res. 2013;7(3):525–8.PubMedCentralPubMed
9.
11.
go back to reference Yu CW, Hsu CY, Shih TTF, Chen BB, Fu CJ. Vertebral osteonecrosis: MR imaging findings and related changes on adjacent levels. AJNR Am J Neuroradiol. 2006;28:42–7. Yu CW, Hsu CY, Shih TTF, Chen BB, Fu CJ. Vertebral osteonecrosis: MR imaging findings and related changes on adjacent levels. AJNR Am J Neuroradiol. 2006;28:42–7.
12.
go back to reference Lakhwani S, Raya JM, González-Brito G, Álvarez-Argüelles H, Brito ML, Hernández-Nieto L. Reversible bone marrow necrosis after all-trans retinoic acid induction therapy for acute promyelocytic leukaemia. Pathology. 2011;43:515–7.PubMedCrossRef Lakhwani S, Raya JM, González-Brito G, Álvarez-Argüelles H, Brito ML, Hernández-Nieto L. Reversible bone marrow necrosis after all-trans retinoic acid induction therapy for acute promyelocytic leukaemia. Pathology. 2011;43:515–7.PubMedCrossRef
13.
go back to reference Libicher M, Appelt A, Berger I, Baier M, Meeder P-J, Grafe I, et al. The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures: results from a radiological and histological study. Eur Radiol. 2007;17:2248–52.PubMedCrossRef Libicher M, Appelt A, Berger I, Baier M, Meeder P-J, Grafe I, et al. The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures: results from a radiological and histological study. Eur Radiol. 2007;17:2248–52.PubMedCrossRef
14.
go back to reference Ramamoorthy SK, Marangolo M, Durrant E, Akima S, Gottlieb DJ. Unusual reaction to Rituximab with intra-vascular hemolysis, rhabdomyolysis, renal failure and bone marrow necrosis. Leuk Lymphoma. 2006;47:747–50.PubMedCrossRef Ramamoorthy SK, Marangolo M, Durrant E, Akima S, Gottlieb DJ. Unusual reaction to Rituximab with intra-vascular hemolysis, rhabdomyolysis, renal failure and bone marrow necrosis. Leuk Lymphoma. 2006;47:747–50.PubMedCrossRef
15.
go back to reference Heo DH, Choi JH, Kim MK, Choi HC, Jeong JH, Chin DK, et al. Therapeutic efficacy of vertebroplasty in osteoporotic vertebral compression fractures with avascular osteonecrosis. Spine. 2012;37:E423–9.PubMedCrossRef Heo DH, Choi JH, Kim MK, Choi HC, Jeong JH, Chin DK, et al. Therapeutic efficacy of vertebroplasty in osteoporotic vertebral compression fractures with avascular osteonecrosis. Spine. 2012;37:E423–9.PubMedCrossRef
Metadata
Title
Spinal bone marrow necrosis with vertebral compression fracture: differentiation of BMN from AVN
Authors
J. S. Nix
R. T. Fitzgerald
R. S. Samant
M. Harrison
E. J. Angtuaco
Publication date
01-09-2014
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 9/2014
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-014-1906-6

Other articles of this Issue 9/2014

Skeletal Radiology 9/2014 Go to the issue