Chronic recurrent multifocal osteomyelitis demonstrated by Tc-99m methylene diphosphonate bone scan
Lise Hobolth1, Michel Nemery, Jens Albrectsen
1Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, Hvidovre, Denmark. lise.hobolth@hvh.regionh.dk
Clinical Nuclear Medicine
|December 22, 2007
Summary
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare condition that can mimic other diseases. This case highlights CRMO
Area of Science:
- Pediatric rheumatology
- Pediatric orthopedics
- Medical imaging
Background:
- Crohn's disease is an inflammatory bowel disease that can affect multiple body systems.
- Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory bone disorder.
- Differentiating CRMO from other conditions like Crohn's disease is crucial for appropriate management.
Observation:
- A 12-year-old girl presented with abdominal pain, weight loss, and thigh pain.
- Initial evaluations for Crohn's disease were negative.
- Bone scintigraphy and MRI revealed inflammatory changes in the femurs.
Findings:
- Percutaneous bone biopsy confirmed chronic recurrent multifocal osteomyelitis (CRMO).
- The patient experienced spontaneous symptom resolution followed by recurrence 1.5 years later.
- Follow-up bone scan showed normal findings after recurrence.
Implications:
- CRMO should be considered in the differential diagnosis of pediatric bone pain, especially when other causes are excluded.
- Advanced imaging techniques like bone scintigraphy and MRI are valuable in diagnosing CRMO.
- The variable presentation and course of CRMO underscore the need for careful monitoring and individualized treatment approaches.
