Pediatrics & Therapeutics
Open Access

Abstract

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

Heleen M Staal, Marjolein HG Dremmen, Simon GF Robben, Adhiambo MA Witlox and Lodewijk W van Rhijn

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.