Intraosseous fat necrosis and metaphyseal osteonecrosis in a patient with chronic pancreatitis: MR imaging and CT scanning.

Necrosis of fatty bone marrow is an unusual complication of several pancreatic disorders. We describe a patient with polyarthritis, sterile subcutaneous abscess and osteolysis arising during the course of alcoholic chronic pancreatitis. MR images of one knee showed multiple foci of abnormal signal intensity within the marrow of the distal femur and proximal tibia, consistent with intraosseous fat necrosis. CT scans showed significant changes in the cancellous bone in these areas compatible with metaphyseal osteonecrosis.