What is the role of imaging studies in the diagnosis of sickle cell disease (SCD)?

Updated: May 12, 2021
  • Author: Joseph E Maakaron, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Imaging studies that aid in the diagnosis of sickle cell anemia in patients in whom the disease is suggested clinically include the following:

  • Radiography: Chest x-rays should be performed in patients with respiratory symptoms

  • MRI: Useful for early detection of bone marrow changes due to acute and chronic bone marrow infarction, marrow hyperplasia, osteomyelitis, and osteonecrosis

  • CT scanning: May demonstrate subtle regions of osteonecrosis not apparent on plain radiographs in patients who are unable to have an MRI [4] and to exclude renal medullary carcinoma in patients presenting with hematuria

  • Nuclear medicine scanning: 99mTc bone scanning detects early stages of osteonecrosis; 111In WBC scanning is used for diagnosing osteomyelitis

  • Transcranial Doppler ultrasonography: Can identify children with SCD at high risk for stroke

  • Abdominal ultrasonography: May be used to rule out cholecystitis, cholelithiasis, or an ectopic pregnancy and to measure spleen and liver size

  • Echocardiography: Identifies patients with pulmonary hypertension

  • Transcranial near-infrared spectroscopy or cerebral oximetry: Can be used as a screening tool for low cerebral venous oxygen saturation in children with SCD

See Workup for more detail.


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