Marrow signal changes in the pediatric population are often complex and can appear nonspecific to the inexperienced radiologist. Normal physiological marrow changes from birth to adulthood play a confounding role. A good understanding for diffuse marrow replacing processes that demonstrate T1 hypointense signal on MRI is crucial for the radiologist to correctly identify pathology, provide early and pathology-specific treatment, and ultimately play a profound role in patient care. The purpose of this educational exhibit is to review the various pathological etiologies of diffuse T1 hypointense marrow signal changes in the pediatric patient, including sickle cell anemia, gaucher’s disease, leukemia, diffuse marrow metastasis, osteomyelitis, thalassemia, juvenile inflammatory arthritis, and bone marrow edema syndromes. Additionally, potential pitfalls will be discussed including red marrow hyperplasia, treatment related changes, immobilization/stress reaction, and normal residual red marrow. Case examples will be provided along with pearls that will aid the radiologist in narrowing their differential diagnosis when faced with specific clinical scenarios. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Patel Paras, Amar Jaspreet, Poletto Erica

Keywords: Bone, Marrow, Pathological

Osteochondromas are the most common bone tumor, accounting for 10-15% of all bone tumors. They are prevalent in the pediatric population and are hypothesized to be a developmental anomaly rather than a true neoplasm, frequently asymptomatic and found incidentally. Although usually sporadic and benign, osteochondromas can be associated with Multiple Hereditary Exostoses (MHE) and Trevor disease or can arise after trauma or radiation treatment. In such cases, complications are more common. A good understanding of these complications and their associated radiologic findings is crucial to identify and differentiate variants that will guide treatment. The purpose of this educational exhibit is to review the typical radiologic presentation of osteochondromas using a variety of imaging modalities including X-Ray, MRI, CT, ultrasound, and nuclear medicine scans. Additionally, imaging appearances of complications and variants of osteochondromas such as MHE, malignant degeneration, associated fracture, bursa formation, and tendon or nerve impingement will be discussed. Case examples will be used to highlight these findings and correlate them to patient presentation. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Bhat Vipul, Motlak Miriam, Germaine Pauline, Poletto Erica

Keywords: Osteochondral, Musculoskeletal