The Use of Whole-Body MR Imaging in Children with HMO, an Extended Case Study in Two Patients

Heleen M Staal,Marjolein Hg Dremmen

doi:10.4172/2161-0665.1000275

Heleen M Staal, Marjolein Hg Dremmen

Open Access

https://doi.org/10.4172/2161-0665.1000275

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Abstract

Background: Patients with hereditary multiple osteochondromas (HMO) undergo frequent radiographs to evaluate the growth of their osteochondromas. The conventional radiographic images clearly show the growth of the bony part of the osteochondromas and the growth direction of the long bones. The radiographs do not show the cartilage cap on top of the osteochondroma nor do they show the surrounding soft tissue or the cartilage of the nearby epiphysis. Alongside these disadvantages taking frequent radiographs carries the potential risk of inducing malignant degeneration through ionizing radiation. In this study we investigated the use of whole-body MR imaging as a screening tool to follow patients with HMO. Findings: Two HMO affected children underwent two whole-body MR imaging scans in one-year time to identify the osteochondromas and to evaluate their growth. The MR images were compared to regular follow-up radiographs of these patients. All radiographically detectable osteochondromas were visible on the whole-body MR images. At least one osteochondroma was clearly seen on the whole-body MR images before detection was possible on the radiographs. The proton density sequence with fat suppression proved to be the best sequence to visualize osteochondromas. Conclusion: Whole-body MR imaging is an effective follow-up tool for patients with hereditary multiple osteochondromas.

Highlights

Hereditary multiple osteochondromas or exostosis (HMO or HME) is an autosomal dominant inherited disease caused by mutated exostosin genes
In total 64 osteochondromas were found on the conventional radiographs of the long bones of the two patients
All osteochondromas that were detectable on conventional radiographs could be identified on the Wb MR images

Summary

Introduction

Hereditary multiple osteochondromas or exostosis (HMO or HME) is an autosomal dominant inherited disease caused by mutated exostosin genes. The osteochondromas grow on the external surface of bones and contain a bone marrow cavity continuous with the normal bone cavity [1,2] They often occur at the metaphysis of the long bones but are found on the spine, scapulae, the ribs and the pelvis. The radiographs do not show the cartilage cap on top of the osteochondroma nor do they show the surrounding soft tissue or the cartilage of the nearby epiphysis. Alongside these disadvantages taking frequent radiographs carries the potential risk of inducing malignant degeneration through ionizing radiation.

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