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Musculoskeletal
Diagnosis
Non-Trauma
Metabolic Bone Disease
Osteoporosis
Anorexia
Anorexia
Donna G. Blankenbaker, MD, FACR; B. J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Eating disorder that involves limiting amount of food intake, resulting in starvation
            • Osteoporosis and its consequent bone fragility
              • 7x ↑ in fracture risk; may persist despite recovery
              • Greater deficit in bone mineral density if onset of anorexia during adolescence
            • Reduced muscle mass
            • Serous atrophy of marrow associated with true starvation
              • Depletion of both red and yellow marrow elements; extracellular deposition of gelatinous substances

        IMAGING

        • Radiographic Findings

          • CT Findings

            • MR Findings

              Selected References

              1. Singhal V et al: Suboptimal bone microarchitecure in adolescent girls with obesity compared to normal-weight controls and girls with anorexia nervosa. Bone. 122:246-53, 2019
              2. Ecklund K et al: Bone marrow fat content in 70 adolescent girls with anorexia nervosa: magnetic resonance imaging and magnetic resonance spectroscopy assessment. Pediatr Radiol. 47(8):952-62, 2017
              3. Robinson L et al: Eating disorders and bone metabolism in women. Curr Opin Pediatr. 29(4):488-96, 2017
              4. Tabari A et al: Anorexia nervosa: analysis of trabecular texture with CT. Radiology. 283(1):178-85, 2017
              5. Bachmann KN et al: Vertebral strength and estimated fracture risk across the BMI spectrum in women. J Bone Miner Res. 31(2):281-8, 2016
              6. Veronese N et al: Vitamin D status in anorexia nervosa: a meta-analysis. Int J Eat Disord. 48(7):803-13, 2015
              7. Misra M et al: Anorexia nervosa and bone. J Endocrinol. 221(3):R163-76, 2014
              8. Bowden DJ et al: Radiology of eating disorders: a pictorial review. Radiographics. 33(4):1171-93, 2013
              9. Kraeft JJ et al: Imaging findings in eating disorders. AJR Am J Roentgenol. 200(4):W328-35, 2013
              10. Bredella MA et al: Distal radius in adolescent girls with anorexia nervosa: trabecular structure analysis with high-resolution flat-panel volume CT. Radiology. 249(3):938-46, 2008
              11. Galusca B et al: Constitutional thinness: unusual human phenotype of low bone quality. J Clin Endocrinol Metab. 93(1):110-7, 2008
              12. Polito A et al: Body composition changes in anorexia nervosa. Eur J Clin Nutr. 52(9):655-62, 1998
              Related Anatomy
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              Related Differential Diagnoses
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              References
              Tables

              Tables

              KEY FACTS

              • Terminology

                • Imaging

                  • Clinical Issues

                    TERMINOLOGY

                    • Definitions

                      • Eating disorder that involves limiting amount of food intake, resulting in starvation
                        • Osteoporosis and its consequent bone fragility
                          • 7x ↑ in fracture risk; may persist despite recovery
                          • Greater deficit in bone mineral density if onset of anorexia during adolescence
                        • Reduced muscle mass
                        • Serous atrophy of marrow associated with true starvation
                          • Depletion of both red and yellow marrow elements; extracellular deposition of gelatinous substances

                    IMAGING

                    • Radiographic Findings

                      • CT Findings

                        • MR Findings

                          Selected References

                          1. Singhal V et al: Suboptimal bone microarchitecure in adolescent girls with obesity compared to normal-weight controls and girls with anorexia nervosa. Bone. 122:246-53, 2019
                          2. Ecklund K et al: Bone marrow fat content in 70 adolescent girls with anorexia nervosa: magnetic resonance imaging and magnetic resonance spectroscopy assessment. Pediatr Radiol. 47(8):952-62, 2017
                          3. Robinson L et al: Eating disorders and bone metabolism in women. Curr Opin Pediatr. 29(4):488-96, 2017
                          4. Tabari A et al: Anorexia nervosa: analysis of trabecular texture with CT. Radiology. 283(1):178-85, 2017
                          5. Bachmann KN et al: Vertebral strength and estimated fracture risk across the BMI spectrum in women. J Bone Miner Res. 31(2):281-8, 2016
                          6. Veronese N et al: Vitamin D status in anorexia nervosa: a meta-analysis. Int J Eat Disord. 48(7):803-13, 2015
                          7. Misra M et al: Anorexia nervosa and bone. J Endocrinol. 221(3):R163-76, 2014
                          8. Bowden DJ et al: Radiology of eating disorders: a pictorial review. Radiographics. 33(4):1171-93, 2013
                          9. Kraeft JJ et al: Imaging findings in eating disorders. AJR Am J Roentgenol. 200(4):W328-35, 2013
                          10. Bredella MA et al: Distal radius in adolescent girls with anorexia nervosa: trabecular structure analysis with high-resolution flat-panel volume CT. Radiology. 249(3):938-46, 2008
                          11. Galusca B et al: Constitutional thinness: unusual human phenotype of low bone quality. J Clin Endocrinol Metab. 93(1):110-7, 2008
                          12. Polito A et al: Body composition changes in anorexia nervosa. Eur J Clin Nutr. 52(9):655-62, 1998