Chronic Recurrent Multifocal Osteomyelitis: <i>Review</i>

Iyer, Ramesh S.; Thapa, Mahesh; Chew, Felix S.

doi:10.2214/ajr.09.7212

Cited by 92 publications

(71 citation statements)

References 41 publications

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“…We found lesions in the patella and the metatarsals, which have rarely been described [6,19]. Our data confirm that epiphyseal involvement and periosteal reaction without mass effect are part of the spectrum of CRMO [7,9,10], including the periost of the spine and sacrum, and are not as rare as previously reported [20,21]. The large variety of locations highlights the necessity to completely include the whole skeleton in the WB-MRI.…”

Section: Kinderradiologie 659supporting

confidence: 83%

Typical Patterns of Bone Involvement in Whole-Body MRI of Patients with Chronic Recurrent Multifocal Osteomyelitis (CRMO)

Kalle

Heim

Hospach

et al. 2013

Fortschr Röntgenstr

102

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Purpose: The diagnosis of CRMO often involves a long patient history. We evaluated the spectrum of bone involvement in whole-body magnetic resonance imaging (WB-MRI) and assessed its potential contribution to a more rapid diagnosis. Materials and Methods: WB-MRI (1.5?T, coronal STIR sequences) in 53 children and adolescents (mean age 11 years, 4.8???15.1) with histologically (n?=?37) or clinically (n?=?16) confirmed CRMO were retrospectively reviewed by two experienced pediatric radiologists. Results: WB-MRI revealed multifocal lesions in all but one patients. Only 26 of them had presented with multifocal complaints. We detected 1???27 geographic lesions/patient (mean 9.7). 510 of 513 lesions were significantly hyperintense compared to normal bone marrow. The pelvis, lower extremities, shoulders and spine were most frequently involved. 40 patients (75?%) had bilateral symmetrical involvement of bones. Most of the lesions were located in tubular bones, in 87?% adjacent to one or both sides of a growth plate. 32?% of lesions showed periosteal involvement. Of 456 affected bones, 33 (7.2?%) were deformed, 6 (18?%) were vertebra plana. Conclusion: In the absence of more specific diagnostic criteria, WB-MRI can, in synopsis with clinical findings, substantially contribute to a rapid diagnosis of CRMO. It discovers the typical pattern of multifocal and bilateral bone involvement more often than has been reported for targeted MRI. It readily reveals the characteristic proximity of lesions to growth plates, the sacroiliac joint and triradiate cartilage and helps to uncover asymptomatic spinal complications.

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Section: Kinderradiologie 659supporting

confidence: 83%

Typical Patterns of Bone Involvement in Whole-Body MRI of Patients with Chronic Recurrent Multifocal Osteomyelitis (CRMO)

Kalle

Heim

Hospach

et al. 2013

Fortschr Röntgenstr

102

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“…The spinal involvement caused by CRMO may progress to vertebral body collapse, occasionally with vertebral plana appearance. These findings are indistinguishable from malignancy on the radiography [35,40], but the lack of additional malignant features on the surrounding soft tissues on the MRI may suggest the correct diagnosis. MRI sequences with fat suppression techniques, like short tau inversion recovery (STIR), are important to study the soft tissues and are especially useful for the diagnosis and follow-up of these patients [41].…”

Section: Imagingmentioning

confidence: 86%

“…The duration of active disease has been linked to the initial and total number of bone lesions and inversely correlated with the age of onset [10,40]. It has also been described that CRMO can evolve into a spondyloarthropathy, with clinical and radiological sacroiliitis [19].…”

Section: Clinical Improvementmentioning

confidence: 99%

Chronic Recurrent Multifocal Osteomyelitis

Costa-Reis

Sullivan

2013

J Clin Immunol

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Chronic recurrent multifocal osteomyelitis is a rare auto-inflammatory condition that primarily affects children and adolescents. It presents with recurrent episodes of pain related to the presence of foci of sterile bone inflammation. The long bones of the lower extremities are more frequently affected and the spine can also be involved. Imaging studies, including whole-body magnetic resonance, are important for diagnosis and detection of asymptomatic lesions. Bone biopsies may be necessary to exclude other diseases, including malignancy and infections. Non-steroidal anti-inflammatory drugs cause relief of symptoms in the majority of cases. Bisphosphonates and TNF-α blockers are alternatives for patients who do not respond or who have spinal involvement.

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“…Since the blood and tissue cultures are negative, a noninfectious inflammatory process is the main culprit. Moreover, considering the relationship of CRMO with multiple autoimmune diseases, an autoimmune disorder is also suspected as the cause of the CRMO (17).…”

Section: Discussionmentioning

confidence: 99%

Chronic Recurrent Multifocal Osteomyelitis: A Case Report

et al. 2017

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Introduction: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare migratory skeletal disorder with non-infectious inflammatory etiology which usually causes bone pain in children and adolescents. Intermittent periods of exacerbation and remission are usually noted during the course of the disease. It is a multifocal bone disease usually involving the metaphyses of long bones. The clinical and Paraclinical findings are non-specific, and indeed CRMO is a diagnosis of exclusion based on multiple criteria. Case Presentation: We present a 6-year-old boy with multiple periods of fever, systemic inflammation and bone pain since he was 2 years old, hospitalized multiple times, received antibiotics and finally diagnosed as a CRMO case. Conclusions: CRMO should be diagnosed according to a variety of clinical and paraclinical findings. In children and adolescents with multiple bone lesions and lytic lesion, one of the differential diagnoses that should be considered is CRMO.

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Chronic Recurrent Multifocal Osteomyelitis: Review

Cited by 92 publications

References 41 publications

Typical Patterns of Bone Involvement in Whole-Body MRI of Patients with Chronic Recurrent Multifocal Osteomyelitis (CRMO)

Typical Patterns of Bone Involvement in Whole-Body MRI of Patients with Chronic Recurrent Multifocal Osteomyelitis (CRMO)

Chronic Recurrent Multifocal Osteomyelitis

Chronic Recurrent Multifocal Osteomyelitis: A Case Report

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