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Magnetic resonance imaging (MRI) findings of joints in young beta-thalassemia major patients: fluid surrounding the scaphoid bone: a novel finding, as the possible effect of secondary hemochromatosis.

Karimi M, Jamalian N, Rasekhi A, Kashef S

Hematology Research Center, Department of Radiology, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran. karimim@sums.ac.ir

BACKGROUND: Beta-thalassemia major is a hereditary disease with developing hemochromatosis as a consequence of repeated blood transfusions. Degenerative arthropathy may be the first manifestation of primary hemochromatosis. OBJECTIVE: The aim of this study is to determine the possible effects of secondary hemochromatosis in joints of beta-thalassemia major patients, and to evaluate the sensitivity of magnetic resonance imaging (MRI) compared with plain x-ray, in the early diagnosis of hemochromatosis of the joints. METHODS: Thirty beta-thalassemia major patients were randomly enrolled. A questionnaire regarding their history, careful physical examination, the result of their liver biopsies, and other necessary information were completed for these patients. X-ray and MRI of the left hand and wrist were taken in these patients and also in other 30 healthy people with the same age and sex as the case control group. RESULTS: The prevalence of minimal fluid surrounding the scaphoid bone in MRI was 23.3%, which is a novel and significant finding. Other interesting changes included hypo signal intensity (T1 and T2) in carpal, metacarpal, radius, and ulna bones. CONCLUSIONS: Regarding the availability of special health services for thalassemia patients, this imaging study can be used for the accurate detection of hemochromatosis in joints of thalassemia patients.

Published 6 June 2007 in J Pediatr Hematol Oncol, 29(6): 393-8.
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