Comparison of results of whole-body magnetic resonance imaging scans and traditional imaging modalities in diagnostic management of chronic recurrent multifocal osteomyelitis

Abstract

Introduction: The diagnosis of chronic recurrent multifocal osteomyelitis (CRMO) is frequently the result of excluding other diseases. The only methods that provide images of the multicentricity of radiologically active foci are whole body bone scintigraphy (SCI) and whole body MRI (WBMRI). The objective of the study was to compare the results of WBMRI and traditional imaging modalities in CRMO. Material and methods: The study group consisted of 20 children with the mean age of 9.5 years. WBMRI imaging was performed between June and December of 2014. The mean follow-up period after completion of the study was 35 months. All the patients included in the study were additionally subjected to examination of clinically active CRMO foci by computed tomography, classic radiographic diagnostic management and scintigraphy. Results: All the patients manifested clinically active foci. In the group of the investigated patients, the highest number of foci in concordance with the clinical picture was noted in SCI-29, followed by CT-22 and WBMRI-21, while plain X-ray yielded the lowest number of positive results-12. Conclusions: The results of the present study do not confirm the highest sensitivity of WBMRI in determining possible disease foci in CRMO as compared to other imaging modalities. Higher sensitivity in detection of radiologically active foci in CRMO was noted in bone system scintigraphy. During the 35-month follow-up, none of the WBMRI-detected radiologically active and clinically silent foci underwent clinical activation.