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Case Reports
. 2012 Dec 23;2(1):2047981613477401.
doi: 10.1177/2047981613477401. eCollection 2012.

Iron deposits in the knee joints of a thalassemic patient

Charalambos P Economides  1 , Elpidoforos S Soteriades, Michalis Hadjigavriel, Ioannis Seimenis, Apostolos Karantanas
Affiliations
Case Reports

Iron deposits in the knee joints of a thalassemic patient

Charalambos P Economides et al. Acta Radiol Short Rep. .

Abstract

The overall prognosis for patients with β-thalassemia has improved considerably during the past decades mainly due to regular blood transfusions, improvements in chelation therapy, and enhanced surveillance with imaging studies examining iron overload and other clinical complications. However, the prolonged survival of these patients leads to the development of other health problems including degenerative diseases such as arthropathies, which require further attention since they have a significant impact on the quality of life. In the current case report, we present a 45-year-old white man with β-thalassemia complaining of non-traumatic pain and restriction in the range of motion of both knees. Magnetic resonance imaging (MRI) revealed a tear in the medial meniscus of the left knee as well as iron deposits in both knees. Histological findings confirmed the presence of hemosiderin in both joints. To our knowledge, this is the first reported case of macroscopically documented iron deposits in the knee joints of a patient with β-thalassemia using MRI.

Keywords: MR imaging; arthritides; hematologic diseases; knee.

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Figures

Fig. 1
Fig. 1
A fat-suppressed, PD-w image in the coronal plane of the left knee shows a longitudinal tear in the body of medial meniscus (long arrow) and the displaced meniscal fragment within the intercondylar notch (short arrow). In addition, osteoarthritic changes with minimal subcortical cyst formations and reactive bone marrow edema are noted in the medial tibial plateau (open arrow)
Fig. 2
Fig. 2
(a) A T2*-w sagittal image in the left knee represents foci of iron deposits within the supra patellae pouch right above the superior pole of the patellae (short arrow) and also in contact with the patellae cartilage at the upper pole (long arrow), as well as within the Hoffa's fat pad in contact with the patellae cartilage in its inferior pole (open arrow) and in the cartilage surface over the trochlea (doted arrow). (b) A fat-suppressed PD-w image in the sagittal plane in the left knee shows foci of iron deposition along the surface of the cartilage over the lateral trochlea (short arrow). We note the drop of signal in the area of iron deposits, which is less prominent in comparison with the corresponding T2*-w image
Fig. 3
Fig. 3
This image represents four corresponding axial images from different pulse sequences of the left knee. (a) is a T2*-w image, (b) is an ultra short time echo (UTE) image, (c) was obtained with susceptibility weighted imaging (SWI), and (d) represents PD-w imaging with a turbo spin echo sequence. In (a), we note a large area of iron deposit in contact with the patellae and trochlea groove cartilage presented as a low signal intensity focus (arrow). In (b) and (c) we highlight a further exaggeration of the signal loss in the area of iron deposits on the UTE and SWI sequences, respectively (arrows). In (d) we note less conspicuous signal loss of the iron deposit area in the PD-w sequence (arrow)
Fig. 4
Fig. 4
A T2*-w sagittal image of the right knee obtained with a gradient recalled echo (GRE) pulse sequence. Iron deposits are noted in contact with the inferior pole of the patellae cartilage (short arrow), as well as in contact with the anterior cartilage surface of the lateral femoral condyle (long arrow)
See this image and copyright information in PMC

References

    1. Anderson LJ, Westwood MA, Prescott E, et al. Development of thalassaemic iron overload cardiomyopathy despite low liver iron levels and meticulous compliance to desferrioxamine. Acta Haematol 2006;115:106–8 - PubMed
    1. Chan Y, Li C, Chu WC, et al. Deferoxamine induced bone dysplasia in the distal femur and patella of pediatric patients and young adults: MR Imaging Appearance. Am J Roentgenol 2000;175:1561–6 - PubMed
    1. Anderson LJ, Westwood MA, Holden S, et al. Myocardial iron clearance during reversal of siderotic cardiomyopathy with intravenous desferrioxamine: a prospective study using T2* cardiovascular magnetic resonance. Br J Haematol 2004;127:348–55 - PubMed
    1. de Assis RA, Ribeiro AA, Kay FU, et al. Pancreatic iron stores assessed by magnetic resonance imaging (MRI) in beta thalassemic patients. Eur J Radiol 2012;81:1465–70 - PubMed
    1. Chand G, Chowdhury V, Manchanda A, et al. Deferiprone-induced arthropathy in thalassemia: MRI findings in a case. Indian J Radiol Imaging 2009;19:155–7 - PMC - PubMed

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