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JUNE 2011
Volume 41, No. 6


Musculoskeletal Imaging

Posttransplant Distal Limb Syndrome

Joseph A. Shrader, Galen O. Joe

DOI: 10.2519/jospt.2011.0412



The patient was a 45-year-old woman who was referred to a physical therapist and a physiatrist in a rehabilitation medicine department for evaluation and treatment of severe bilateral lower leg, ankle, and foot pain. The patient’s past medical history was significant for sickle cell disease and she had undergone an allogeneic stem cell transplant 4 months prior with Sirolimus prescribed to prevent rejection. Magnetic resonance imaging of both lower legs revealed extensive bone marrow edema, as well as soft tissue swelling about the lower legs and ankles. These findings, along with the patient’s presentation (constant bilateral pain and erythema of the lower legs within 6 months of transplantation) were found to be consistent with an atypical condition called posttransplant distal limb syndrome.

J Orthop Sports Phys Ther 2011;41(6):458. doi:10.2519/jospt.2011.0412

KEY WORDS: ankle, foot, leg, magnetic resonance imaging, radiography


The patient was a 45-year-old woman who was referred to a physical therapist and a physiatrist in a rehabilitation medicine department for evaluation and treatment of severe bilateral lower leg, ankle, and foot pain.


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