대한근골격영상의학회

Title : Case 761

Age / Sex : 54 / F Chief complaint : Rt. Knee and left ankle pain Hisotory: GIST, s/p PPPD, cholecystectomy, omentectomy Gleevec medication during 9 months Trauma history (-) Diagnosis: Drug induced bone marrow edema syndrome due to Imatinib (Gleevec) Discussion Findings 1.Multifocal patchy BM lesions at distal femur and proximal tibia - most prominent at the medial femoral condyle and tibial tuberosity - high SI on FS T2WI, with enhancement - associated diffuse SQ edema 2.Multifocal nonspecific BM edema at distal tibia, talus (near the sinus tarsi) and navicular bone Differential diagnosis(보내주신 감별진단만 semi-correct로 인정 합니다) 1.Idiopathic bone marrow edema syndrome 2.Osteonecrosis 3.Insufficiency fracture Short review and references Drug induced bone marrow edema syndrome Imatinib (Gleevec) Chronic myeloid leukemia and GIST Most common adverse events : soft tissue edema and fluid retention Dose related (greater than 600 mg/dL) Uncommon Bone related adverse event Usually mild bone pain or arthralgia Transient bone marrow edema Osteonecrosis Insufficiency fracture

Title : Case 761

Age / Sex : 54 / F

Chief complaint : Rt. Knee and left ankle pain

Hisotory:

GIST, s/p PPPD, cholecystectomy, omentectomy

Gleevec medication during 9 months

Trauma history (-)

Diagnosis:

Drug induced bone marrow edema syndrome due to Imatinib (Gleevec)

Findings

1.Multifocal patchy BM lesions at distal femur and proximal tibia

- most prominent at the medial femoral condyle and tibial tuberosity

- high SI on FS T2WI, with enhancement

- associated diffuse SQ edema

2.Multifocal nonspecific BM edema at distal tibia, talus (near the sinus tarsi) and navicular bone

Differential diagnosis(보내주신 감별진단만 semi-correct로 인정 합니다)

1.Idiopathic bone marrow edema syndrome

2.Osteonecrosis

3.Insufficiency fracture

Short review and references

Drug induced bone marrow edema syndrome
Imatinib (Gleevec)

Chronic myeloid leukemia and GIST

Most common adverse events : soft tissue edema and fluid retention

Dose related (greater than 600 mg/dL)

Uncommon Bone related adverse event

Usually mild bone pain or arthralgia

Transient bone marrow edema

Osteonecrosis

Insufficiency fracture

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