Bone infarcts are seen in

a. Iron deficiency anemia.
b.Thalassaemia.
c. Sickle cell anemia
d. Hereditary spherocytosis.

Ans: C


Proposed risk factors include:
-Chemotherapy,
-Alcoholism
-Excessive steroid use
-Post trauma
-Caisson disease (decompression sickness)
-Vascular compression
-Hypertension
-Vasculitis
-Arterial embolism and thrombosis
-Damage from radiation
-Bisphosphonates (particularly the mandible)
-Sickle cell anaemia
-Gaucher's Disease
-Deep diving.




Bone infarcts are often thought to be in the same spectrum of disease as osteonecrosis
occurs within the metaphysis or diaphysis of long bone.

Interruption of blood supply by intrinsic or extrinsic factors is the cause.

Usually asymptomatic, often found when imaging the extremities for other reasons.

Radiograhs- medullary lesion of sheet-like central lucency surrounded by sclerosis with a serpiginous border "smoke up the chimney".

MRI- key feature is that central signal remains of normal marrow
T1 weighted images
peripheral low signal due to grannulation tissue and to lesser extent sclerosis
periphery may enhance post gadolinium
T2 weighted images
acute infarct may show ill-defined non-specific area of high signal
intense inner ring of granulation tissue and a hypointense outer ring of sclerosis

Bone Scan
cold in early phases
hot in late resorptive and revascularisation phase.

Treatment:
Nonoperative- Observation.