Prevalence of phalangeal bone marrow edema on MRI before and during the COVID-19 pandemic and correlation with chilblain skin lesions

• Published in: Skeletal radiology Vol. 52; no. 9; pp. 1721 - 1728
• Main Authors: da Silva, Lucas N. M., Guimarães, Júlio Brandão, Link, Thomas M., da Cruz, Isabela A. N., Silva, Flavio Duarte, Nico, Marcelo Astolfi Caetano, Filho, Alípio Gomes Ormond
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-09-2023; Springer; Springer Nature B.V
• Subjects: Adult; Bone marrow; Bone Marrow - diagnostic imaging; Bone Marrow - pathology; Bone Marrow Diseases - epidemiology; Chilblains - diagnostic imaging; Chilblains - epidemiology; COVID-19; COVID-19 - epidemiology; Dropsy; Edema; Edema - pathology; Epidemiology; Erythema; Female; Health aspects; Humans; Imaging; Infection; Lesions; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Nuclear Medicine; Orthopedics; Pandemics; Pathology; Prevalence; Radiology; Retrospective Studies; Scientific; Scientific Article; Skin; Skin Diseases; Skin lesions; Vaccination; COVID-19; Chilblains; MRI; COVID-toes
• ISSN: 0364-2348; 1432-2161
• DOI: 10.1007/s00256-023-04337-0

Objective
The purpose of this study is to establish the prevalence bone marrow edema of the phalanges of the feet and hands before and during the COVID-19 pandemic on MRI studies and correlate with clinically chilblain skin lesions and epidemiological data.
Methods
This observational retrospective study. In patients with confirmed bone marrow edema of the phalanges, epidemiological data and clinical findings were collected, including the history of current or remote COVID-19 infection and vaccination status. The two-proportion test was used to compare the frequency of bone marrow edema in the phalanges before and during the pandemic, and the comparison between the categories variables was performed using the one-proportion test.
Results
Of the total of 7215 patients, only 20 presented isolated bone marrow edema of the digits in MRI studies; 2 (0.05%) were found two years before the pandemic’s beginning, and 18 (0.64%) after the pandemic’s onset, demonstrating an increase of 13-fold in this period. 16 were women with a mean age of 40.3 years and 4 were men with a mean age of 53.5 years. The most frequently reported clinical symptoms by the patients were pain (85.0%), and erythema of the skin (45.0%). Of the 18 patients found after the pandemic’s onset, only 27.8% had COVID-19 infections confirmed by RT-PCR before the imaging study, and all cases were mild.
Conclusion
This study demonstrated a significant increase in the prevalence of bone marrow edema of the phalanges after the onset of the COVID-19 pandemic, particularly in middle-aged and younger women.