Soft tissue signal abnormality associated with eosinophilic granuloma

Six patients with eosinophilic granuloma were studied retrospectively in order to correlate the MRI appearances with the pathology. Ages ranged from 2 years 6 months to 11 years. The bones involved were the humerus, ulna, radius, femur, clavicle and ilium. Plain films, MRI and pathology specimens were obtained. A lytic lesion with indistinct margins, endosteal erosions and periosteal reaction was seen in all cases on plain radiographs. Bone marrow signal was decreased on T1-weighted images and increased on T2-weighted images throughout the bony lesion in all cases. T2-weighted images showed extensive soft-tissue abnormalities suggesting inflammatory changes in four cases. In two cases abnormalities were limited. Extensive changes correlated histologically with an early phase lesion. Localized minor changes were associated with a mid-phase lesion. Inflammatory soft-tissue changes could be associated with eosinophilic granuloma. The size of the soft tissue mass correlated well with the activity of the bony lesion.