Craniofacial bone infarcts in sickle cell disease: clinical and radiological manifestations.

OBJECTIVE

To investigate the clinicoradiological manifestations of craniofacial bone infarcts in patients with sickle cell disease (SCD).

METHODS

After institutional review board approval, we identified 85 SCD patients who underwent head and neck magnetic resonance imaging (MRI) during a period of 5 years (January 1, 2004-December 31, 2008) and reviewed their clinical presentations and radiological findings.

RESULTS

Of 40 subjects with headache or facial pain, 6 (5 males, 1 female; age range, 2-22 years; 5 Hb SS, 1 Hb SC) were diagnosed with acute bone infarct by MRI. Of these 6, 4 demonstrated infarcts in the mandible. Magnetic resonance images showed bone marrow edema, subperiosteal fluid collections with susceptibility effects suggesting associated hemorrhage, and heterogeneous enhancement.

CONCLUSIONS

Acute craniofacial bone infarcts were found in 7% of SCD patients who underwent MRI and in 15% of SCD patients who presented with pain. The MRI showed characteristic imaging findings including marrow edema, subperiosteal hematoma, and heterogeneous enhancement.