Purpose or Case Report: Phalangeal micro geodic disease (PMD)/ transient phalangeal osteolysis is a rare self-limiting condition for which there are limited published case reports. There have been an increasing number of cases over the last thirteen years dating back to 2001. We present several paediatric cases diagnosed as PMD over the last ten years and their imaging features, often overlapping with inflammatory or infective arthropathy. PMD has a higher occurrence after cold exposures and thus seen in colder regions. It has also been described to favor the fingers over the toes.
This is a pictorial review that highlights the imaging findings of PMD to enable a smoother journey from presentation to diagnosis for both our Radiological and Clinical colleagues.
Methods & Materials: This pictorial review uses a retrospective search for diagnosed PMD cases on the database over the last ten years. These cases were then analysed to collect clinical and radiological findings to compare them to one another.
Results: Most patients had MRI of their affected phalanges which demonstrated one or several of the following findings; marrow oedema, erosions, and soft tissue oedema. Many patients also underwent plain film radiography of the affected bones which were either normal or demonstrated destructive bony features such as erosions or soft tissue swelling.
Conclusions: PMD is an under recognized and under diagnosed condition. With its self-limiting nature, the treatment of PMD is based on conservative management options including but limited to, keeping the affected region warm, splinting to avoid fractures/contractures and if dual diagnosed with an underlying arthropathy then medical management. It is important to raise suspicions of PMD earlier in a patient’s journey to reduce referrals for biopsies and reduce the risk of inappropriate management.