びまん性硬化性下顎骨骨髄炎の診断と治療

Abstract

Diffuse sclerosing osteomyelitis of the mandible (DSO) is the intractable inflammatory disease of bone, characterized by recurrent pain, swelling, and trismus in the absence of pus formation, fistula, or sequestration. Radiographically, it presents as intermingled sclerotic and osteolytic lesions with solid periosteal reaction or external bone resorption. Various hypotheses have been discussed about the etiology, including an immunologic reaction to microbial stimuli, chronic tendo-periostitis owing to muscular overuse and as part of systemic syndrome such as chronic recurrent multifocal osteomyelitis (CRMO) or SAPHO syndrome. This clinical review of DSO focuses on the diagnostic criteria, the relationship with CRMO and SAPHO syndrome, the transition of the etiology and various therapies and the effect. In addition, this review shows the low dose pamidronate disodium therapy for DSO in our facility.