serous bone marrow transformation starts at the toes

Here a case of an athlete with a relative energy deficiency in sport (RED-S), that develops a serous bone marrow transformation within just 3 months.

https://vimeo.com/925288722/c81d9b3a56?share=copy

On a side note, we start to see this more frequently now (since the panedmic), maybe bias, but studies have shown the same:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088734/

The results of this study demonstrated a thirteenfold increase in the number of patients with isolated bone marrow edema like abnormalities of the digits of the feet and hands during the COVID-19 pandemic as compared to the same time interval before the pandemic. Most cases were found in middle-aged (mean 40.3 ± 14,3 years) female patients (80.0%), with no comorbidities, and a low prevalence of the previous diagnosis of COVID-19 infection (27.8%).

...

This observational study demonstrated a significant increase in the prevalence of isolated bone marrow edema pattern of the phalanges of the hands and feet in patients with pain and erythema (Chilblain) after the onset of the COVID-19 pandemic, especially in young and middle-aged woman without previously confirmed COVID-19 infections.

however in that study, they excluded patients with serous atrophy, so its a DD and not the same. In this case, due to the stress fracture and clinical RED-S, makes a serous atrophy the primary diagnosis.

looking for more interesting cases?

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Please share with colleagues and share your great cases too!

best regards

Chris

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