Chronic recurrent multifocal osteomyelitis.

Brown, Tommy J.; Wilkinson, R H

doi:10.1148/radiology.166.2.3336727

Cited by 64 publications

(28 citation statements)

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“…The main symptom of our patient was recurrent episodes of pain and swelling, without fever. Inflammatory markers can be increased in up to two-thirds of cases, as was reported by Brown and Wilkinson4 in 65% of their 11 patients. This finding also leads the physician to suspect bacterial osteomyelitis, as in our case.…”

Section: Discussionsupporting

confidence: 61%

Chronic recurrent multifocal osteomyelitis: a rare skeletal disorder

et al. 2015

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SUMMARYChronic recurrent multifocal osteomyelitis (CRMO) is a rare non-infectious inflammatory bone disease of unknown aetiology. CRMO mainly affects the metaphyses of long bones and spine in children and young adolescents. It presents with recurrent episodes of bone pain and fever, resembling bacterial osteomyelitis, but cultures of lesions are sterile and it is unresponsive to antibiotic therapy. We report a case of a 3-year-old boy diagnosed with CRMO, who was initially treated for bacterial osteomyelitis, and received prolonged antibiotic therapy for chronic pain, and swelling of mandible and ulna. CRMO should be kept in mind in the differential diagnosis of chronic bone pain and osteomyelitis unresponsive to antibiotic treatment. BACKGROUND

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Section: Discussionsupporting

confidence: 61%

Chronic recurrent multifocal osteomyelitis: a rare skeletal disorder

et al. 2015

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“…Although histiocytosis X remains the most common cause of vertebra plana in children, CRMO is another disease that can cause vertebra plana (49). Since the initial description in 1989, several cases of vertebra plana secondary to CRMO have been reported (49,51,(63)(64)(65). Unlike in vertebra plana caused by eosinophilic granuloma, restitution of vertebral body height has not been observed in vertebra plana caused by CRMO (49).…”

Section: Spinementioning

confidence: 99%

Imaging of Chronic Recurrent Multifocal Osteomyelitis

Khanna¹,

Sato²,

Ferguson³

2009

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Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disorder of children and young adults that is characterized by nonbacterial osteomyelitis. Patients typically present with multifocal bone pain secondary to sterile osseous inflammation, and the disease has a relapsing and remitting course. The cause of CRMO remains unclear, although the results of several studies have suggested a genetic component. The typical imaging findings of CRMO include lytic and sclerotic lesions in the metaphyses of long bones and the medial clavicles. Other common sites of disease are the vertebral bodies, pelvis, ribs, and mandible. CRMO is often bilateral and multifocal at presentation. Owing to the lack of a diagnostic test, CRMO remains a diagnosis of exclusion. Although generally a self-limiting disease, CRMO can have a prolonged course and result in significant morbidity. Radiologists can be the first to suggest this diagnosis given its characteristic radiographic appearance and distribution of disease. Radiologists should be familiar with the typical imaging findings of CRMO to prevent unnecessary multiple biopsies and long-term antibiotic treatment in children with CRMO.

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“…Em todos, os achados dominantes são a hiperostose e a osteíte. Já nas crianças, a doença predomina nos ossos longos, seguidos pelas clavículas e coluna, sendo comumente designada como osteomielite multifocal crônica recorrente (3,8) . 13.…”

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Síndrome SAPHO: entidade rara ou subdiagnosticada?

Guerra¹,

Lima

Macedo

et al. 2005

Radiol Bras

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Guerra JG et al. Radiol Bras 2005;38(4):265271265 correlação entre cinco manifestações clínicas, radiológicas e patológicas freqüentemente combinadas, das quais deriva o acrônimo que a denomina: sinovite, acne, pustulose, hiperostose e osteíte (1-5) .Os componentes fundamentais da síndrome, que pode ser entendida como um conjunto de diversas desordens idiopáticas, são a hiperostose e a osteíte inflamatória. Na presença desses achados, o clínico e o radiologista devem considerar a possibilidade diagnóstica da síndrome (2) .As manifestações cutâneas incluem pustulose e formas graves de acne, tais como acne conglobata. As lesões pustulares usualmente se manifestam ou por psoríase ou por pustulose palmoplantar. No entanto, a ausência de alterações cutâneas não exclui o diagnóstico, pois essas lesões OBJETIVO: Descrever os achados clínicos, radiológicos e patológicos da síndrome SAPHO e sugerir que, apesar de ser considerada rara, esta síndrome deve estar sendo subdiagnosticada por clínicos e radiologistas, provavelmente em função do desconhecimento das suas características. MATERIAIS E MÉTODOS: Foi realizado estudo retrospectivo de seis casos confirmados desta síndrome, dando-se ênfase aos achados clínicos (idade, sexo e sintomas) e de imagem (cintilografia óssea, radiografia convencional, tomografia computadorizada e ressonância magnética). RESULTADOS: A manifestação clínica inicial de todos os pacientes foi dor na parede torácica ântero-superior há pelo menos quatro meses. Todos apresentavam achados de imagem de processo inflamatório e/ou osteíte e hiperostose nas articulações da parede torácica ântero-superior. As alterações cutâneas da síndrome, tipo pustulose palmoplantar, estiveram presentes em cinco dos seis pacientes. Em nenhum dos seis casos o diagnóstico foi sugerido na consulta clínica inicial ou na primeira interpretação das imagens feita por radiologistas não especialistas em sistema músculo-esquelético. CONCLUSÃO: Os nossos achados estão de acordo com os descritos na literatura, devendo ser considerado este diagnóstico em todo paciente que apresente quadro doloroso de parede torácica acompanhado de manifestações dermatológicas e/ou osteíte. Unitermos: Síndrome de hiperostose adquirida; Hiperostose esternocostoclavicular; Psoríase; Osteíte.SAPHO syndrome: rare or under-diagnosed? OBJECTIVE: To describe the clinical, imaging and pathological findings of SAPHO syndrome and to point out that although considered rare this syndrome may be under-diagnosed by clinicians and radiologists, probably due to unfamiliarity with its features. MATERIALS AND METHODS: A retrospective study of six cases diagnosed in the last six years, with emphasis on clinical findings (age, sex and symptoms) and imaging findings (bone scintigraphy, conventional x-ray, computed tomography and magnetic resonance imaging) was conducted. RESULTS: The initial clinical presentation in all patients was pain in the upper anterior chest wall for at least four months. Imaging findings of all these patients indicated inflammatory process and/or hy...

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Chronic recurrent multifocal osteomyelitis.

Cited by 64 publications

References 0 publications

Chronic recurrent multifocal osteomyelitis: a rare skeletal disorder

Chronic recurrent multifocal osteomyelitis: a rare skeletal disorder

Imaging of Chronic Recurrent Multifocal Osteomyelitis

Síndrome SAPHO: entidade rara ou subdiagnosticada?

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