Magnetic resonance imaging was used to study the skeletal involvement in
a series of twenty-four patients with Gaucher disease. Many sites in the
marrow of these patients were characterized by an abnormally low signal
intensity that reflected shortened T1 and markedly shortened T2 values in
the replaced marrow. The abnormality was non-homogeneous in distribution.
In the lower extremity, the proximal (femoral) areas were more frequently
affected than the distal (tibial) sites. The epiphyses were generally
spared unless the involvement of bone was extensive. Lack of epiphyseal
involvement on the magnetic resonance images generally precluded any
suspicion of osteonecrosis. The extent of involvement, as suggested by the
magnetic resonance data, appeared to correlate well with the occurrence of
musculoskeletal complications. Magnetic resonance imaging is more sensitive
than computerized tomography in demonstrating the extent of abnormalities
in patients with Gaucher disease, and it may have prognostic value.