Intended for healthcare professionals

Endgames Spot Diagnosis

Skin changes after a magnetic resonance imaging scan

BMJ 2018; 360 doi: (Published 08 February 2018) Cite this as: BMJ 2018;360:k77
  1. Barian Mohidin, core medical trainee
  1. Royal Free Hospital, London, UK
  1. Correspondence to B Mohidin barian.mohidin{at}

A 54 year old woman with hepatitis C and end stage renal failure of unknown cause (for which she was receiving haemodialysis) had a magnetic resonance imaging scan with gadolinium in 2000. She experienced swelling and erythema of her limbs within 48 hours of the scan. This subsequently developed over months to diffuse aching pains, fibrosis with skin hardening and induration, and progressive weakness in all limbs, with substantial loss of muscle mass (figs 1 2 3). What is the clinical diagnosis?

Fig 1

Skin fibrosis, induration, thickening, and scarring on the lateral aspect of …

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