Abstract：
Secondary anemia in hemoglobinopathies like thalassemia can cause expansion of the bone marrow cavities because of compensatory marrow hyperplasia. This case demonstrates spontaneous osteonecrosis of the distal left femur in a patient with β-thalassemia that may be secondary to ischemic infarction secondary to occlusion of the microvasculature within the expanded cancellous bone. This subject was referred to Hazrat Rasool Akram Hospital because of fever, cough, and bone pain. In the CT scan she had scattered peripheral CGO in both lungs due to COVID-19 with two paravertebral masses due to extramedullary hematopoiesis. The patient had also generalized bone pain so the physician asked for a whole-body bone scan and incidentally, we found a cold lesion with a rim of increased uptake in the distal left femur that with bone biopsy it was consistent with osteonecrosis. This case illustrates the importance of performing a whole-body bone scan in β-thalassemia for the management of patients and diagnosis of occult osteonecrosis.
摘要：
血红蛋白病如地中海贫血的继发性贫血可由于代偿性骨髓增生而导致骨髓腔扩张。此病例表明β-地中海贫血患者的左股骨远端自发性骨坏死，可能是继发于缺血性梗塞，继发于扩张的松质骨内微血管阻塞。该受试者因发烧被转诊至HazratRasoolAkram医院，咳嗽,和骨头疼痛。在CT扫描中，由于COVID-19，她在两肺中都有分散的外周CGO，由于髓外造血，有两个椎旁肿块。患者还患有全身骨痛，所以医生要求进行全身骨骼扫描，顺便说一句，我们在左股骨远端发现了一个冷病变，边缘摄取增加，骨活检与骨坏死一致。此病例说明了在β-地中海贫血中进行全身骨扫描对于患者的管理和隐匿性骨坏死的诊断的重要性。
