Natural history and distribution of bone and bone marrow infarction in sickle hemoglobinopathies.

METHODS Over a period of 11 y, 50 patients (22 males, 28 females; age range, 8 mo to 22 y) presenting with sickle cell-associated bone pain underwent 93 sequential examinations with 99mTc-sulfur colloid bone marrow scanning and 99mTc-diphosphonate bone scanning. Multiple examinations were performed on 21 patients. The number and distribution of total acute, healed, and nonhealed infarcts by location were recorded on a skeletal homunculus. RESULTS For this population, the total number of sites of bone and bone marrow infarction was 464. Of these, 175 were classified as acute by clinical and scintigraphic findings. There were a total of 61 nonhealed sites and 162 healed sites. CONCLUSION Knowledge of the distribution and natural history of sites of bone and bone marrow infarction is of considerable clinical and diagnostic import in the ongoing evaluation and treatment of sickle hemoglobinopathies.