A skeletally immature patient with Diamond-Blackfan anemia with Deferoxamine induced bone dysplasia: An analysis on diffusion tensor imaging.
Sarah L Lu, Camilo Perdomo-Luna, Samuel A Beber et al.
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Case in brief
A 9-year-old boy with Diamond-Blackfan anemia receiving chronic deferoxamine chelation presented with bilateral genu valgum. Alignment radiographs confirmed the deformity, and MRI showed multiple metaphyseal cartilage tongues with abnormal ossification in both distal femurs. Knee diffusion tensor imaging (DTI), obtained to assess physeal integrity before guided growth surgery, showed preserved bilateral physeal tracts and measurements suggesting ongoing physeal activity. He underwent bilateral hemiepiphysiodesis, with early postoperative improvement in alignment.
What made this case unusual
Despite marked metaphyseal abnormalities on conventional MRI, DTI tractography showed preserved physeal microarchitecture. The report describes DTI use in deferoxamine-associated bone dysplasia.
Diagnostic / clinical pearl
In this case, DTI provided information about physeal integrity beyond the metaphyseal abnormalities seen on conventional MRI, helping assess physeal function before guided growth surgery.