Figure 3

Skeletal survey (a), bone scan (b) and STIR coronal images of WB-MRI (c–e) of a 6-year-old boy with a pathologically-confirmed LCH lesion in the right clavicle. The lesion in the clavicle (solid arrow) was detected in all three imaging modalities (a–c); however, the lesion in the T8 vertebral body, appearing as a partially collapsed vertebral body, was noted only on skeletal survey (a) and WB-MRI (d), and the lesion in right first rib was noted only on WB-MRI (e). Although an additional lesion in the right first rib was detected on WB-MRI but not by the skeletal survey, the risk stratifications by WB-MRI and skeletal survey were identical for single system LCH with multiple bone lesions or CNS risk lesions.