Chronic Recurrent Multifocal Osteomyelitis and Inflammatory Bowel Disease

Audu, Grace; Nikaki, Kornilia; Crespi, Daniel; Spray, Christine; Epstein, Jenny

doi:10.1097/mpg.0000000000000663

Cited by 30 publications

(37 citation statements)

References 21 publications

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“…After appropriate tests, UC in association with chronic multifocal osteomyelitis was made. Twenty-seven cases of CRMO in association with IBD had been reported worldwide, and the majority of the affected patients were children [8]. UC symptoms in our patient predated the osteomyelitis symptoms; this is dissimilar to previous reports in which the onset of the bony lesions in the majority of cases preceded that of bowel symptoms by as much as five years [1].…”

Section: Discussioncontrasting

confidence: 83%

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Unusual Manifestation of Ulcerative Colitis

Ahmed

Alsaleem

2019

Case Reports in Pediatrics

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The relationship of inflammatory bowel disease (IBD) and chronic recurrent multifocal osteomyelitis (CRMO) is understood as extraintestinal rheumatic manifestations. CRMO is a chronic, relapsing, inflammatory, noninfectious disorder of the skeletal system of unknown origin. The disease course is not always recurrent. The association of CRMO and ulcerative colitis (UC) is very rarely reported. We report a case of a 10-year-old Saudi female who was diagnosed with CRMO, when she developed fever in association with left foot pain, and ulcerative colitis was confirmed endoscopically and histologically based on a previous settled diarrheal illness and severe iron deficiency anemia which required blood. Both conditions responded well to IBD therapy. To the best of our knowledge, this is the first reported case of chronic, multifocal osteomyelitis associated with pediatric UC in Saudi Arabia. This report supports the use of IBD therapy in treating CRMO.

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Section: Discussioncontrasting

confidence: 83%

“…However, in some case reports, IBD symptoms either preceded or occurred simultaneously with those of CRMO. Seven out of 27 reported cases of CRMO in association with IBD had UC and the rest had Crohn's disease (CD) [8].…”

Section: Discussionmentioning

confidence: 99%

Unusual Manifestation of Ulcerative Colitis

Ahmed

Alsaleem

2019

Case Reports in Pediatrics

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“…Blood cultures and bone biopsies in CRMO do not yield any microbial growth and there is no response to antibiotics. While the aetiology of CRMO has not been firmly established, an autoimmune cause has been postulated and there is a known association with inflammatory bowel disease (10).…”

Section: Pathogenesismentioning

confidence: 99%

The imaging of osteomyelitis

Lee

Sadigh

Mankad³

et al. 2016

Quant. Imaging Med. Surg.

279

221

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Osteomyelitis is an important cause of morbidity and mortality in children and adults. Imaging plays a crucial role in establishing a timely diagnosis and guiding early management, with the aim of reducing long-term complications. Recognition of the imaging features of osteomyelitis requires a good understanding of its pathogenesis. In this review, the key imaging findings in osteomyelitis are correlated with the underlying pathological processes. There is a particular emphasis on magnetic resonance imaging (MRI), which is the best available imaging modality owing to its high sensitivity for detecting early osteomyelitis, excellent anatomical detail and superior soft tissue resolution. However, other modalities such as nuclear medicine and computed tomography (CT) are also useful in many clinical contexts, and will also be described in this review.

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“…DXA may be particularly useful in children with chronic systemic disease requiring long-term systemic steroid treatment and frequent DXA evaluation, for example in children with inflammatory bowel disease in which an association with CRMO has been described [12,13]. The incidental finding of a focal sclerotic bone lesion on DXA, for example, may prompt the suggestion of CRMO as a potential differential diagnosis in the appropriate clinical context.…”

Section: Discussionmentioning

confidence: 99%

Influence of Chronic Recurrent Multifocal Osteomyelitis (CRMO) On Densitometry Measurements Obtained by Dual X-Ray Absorptiometry

Costantini¹,

Marie²,

Kohli³

et al. 2017

J Mol Biomark Diagn

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The incidence of detecting focal chronic recurrent multifocal osteomyelitis (CRMO) lesions on dual-energy x-ray absorptiometry (DXA), and the effect of these lesions on DXA bone mineral density (BMD), bone mineral content (BMC), and their associated Z-scores were retrospectively reviewed. Materials and Methods. The study included 22 patients (14 females, 8 males; median age of 13 years) with CRMO and in whom a total body less head (TBLH) and lumbar spine DXA scan had been obtained. Whole-body bone scintigraphy and MRI were used as the reference standards. Sites involved with CRMO were subsequently detected and DXA measurements were re-measured after removing the sclerotic lesions from the analysis. Results. In total, sclerotic CRMO lesions were detected in 15 of the 22 patients (68%) by DXA, although the number of lesions detected (on a per-lesion analysis) was much less (i.e. 29 of 129 lesions; 19.4%) when compared to MRI and/or bone scintigraphy. Larger lesions had a greater impact on the derived BMD/BMC measurements, and changed the diagnosis in one patient from having normal to abnormal DXA results based on the final Z-score. Discussion. CRMO lesions detected on DXA examinations should be regarded as a potential source of error. Careful inspection and re-quantification of the BMD, BMC and associated Z-score after applying an appropriate correction should be considered in patients with large CRMO lesions identified on DXA examinations.

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Chronic Recurrent Multifocal Osteomyelitis and Inflammatory Bowel Disease

Cited by 30 publications

References 21 publications

Unusual Manifestation of Ulcerative Colitis

Unusual Manifestation of Ulcerative Colitis

The imaging of osteomyelitis

Influence of Chronic Recurrent Multifocal Osteomyelitis (CRMO) On Densitometry Measurements Obtained by Dual X-Ray Absorptiometry

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