Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome: MRI features of intraosseous fat necrosis involving the feet and knees

Skeletal Radiol. 2017 Feb;46(2):279-285. doi: 10.1007/s00256-016-2549-6. Epub 2016 Dec 7.

Abstract

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is extremely rare and presents as a triad of the three diseases. The patient usually presents with mild or absent abdominal symptoms. Here, we report on a case of a 66-year-old male who presented with pain and swelling in both legs and mild abdominal pain. He was diagnosed with acute pancreatitis by pancreatic enzyme analysis and abdominal computed tomography (CT) and with skin lesions of panniculitis through a biopsy. Magnetic resonance imaging (MRI) revealed multifocal intraosseous fat necrosis and arthritis involving both the feet and the knees. Therefore, we report a case of PPP syndrome with intraosseous fat necrosis involving both the feet and the knees.

Keywords: Fat Necrosis; MRI; Pancreatitis; Panniculitis; Polyarthritis.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Aged
  • Arthritis / diagnostic imaging*
  • Biopsy
  • Fat Necrosis / diagnostic imaging*
  • Foot / diagnostic imaging*
  • Humans
  • Knee Joint / diagnostic imaging*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Pancreatitis / diagnostic imaging*
  • Panniculitis / diagnosis*
  • Syndrome
  • Tomography, X-Ray Computed