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[The ribs in beta-thalassemia. Course of the changes in relation to transfusion therapy].

At the present time, the only treatment available to correct the anemia in Cooley's disease is the use of blood transfusions. The patients maintained at a higher baseline level of Hb (Hypertransfusion Regimen = HTR, with Hb levels of 8 divided by 10 g/100 cm3) are in general, in better health and have smaller organs: particularly, the changes in the skull and in other bones become less pronounced and may recede. The authors have reviewed in 77 patients with beta-thalassemia syndromes a spectrum of rib changes, including widening, osteoporosis with or without localized lucencies, "rib-within-a-rib" appearance, subcortical lucency and extramedullary hematopoietic masses. These radiological changes are explained on the basis of the relationship of the proliferating marrow to the medulla, cortex and periosteum. The type of abnormalities depends on the type of transfusion regimen. HTR begun early in life will prevent the development of any abnormal rib changes; on the other hand, in the majority of cases, abnormal findings did not regress with LTR (= Low Transfusion Regimen, with Hb level of 4 divided by 6 g/100 cm3).