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Clinical outcome in children with chronic recurrent multifocal osteomyelitis
C Catalano-Pons1, A Comte, J Wipff
1Service de Pédiatrie Générale, Centre hospitalier d'Avignon, 305, rue Raoul Follereau, 84902 Avignon cedex 9, France. chacatalano@yahoo.fr
Insights
The clinical outcome for most children with chronic recurrent multifocal osteomyelitis (CRMO) is good. However, a significant number experience persistent active disease and pain, indicating a need for further research into severe CRMO cases.
Area of Science:
- Pediatric Rheumatology
- Pediatric Orthopedics
- Pediatric Osteomyelitis
Background:
- Chronic recurrent multifocal osteomyelitis (CRMO) is a rare, non-infectious osteitis affecting children.
- Understanding the long-term clinical outcomes and disease course of CRMO is crucial for effective patient management.
Purpose of the Study:
- To evaluate the clinical outcomes in a cohort of children diagnosed with chronic recurrent multifocal osteomyelitis (CRMO).
- To assess disease activity, physical disability, and long-term sequelae in pediatric CRMO patients.
Main Methods:
- Retrospective review of clinical, biological, and radiological data from five French pediatric centers.
- Utilized hospital chart reviews and patient questionnaires to gather outcome data, including disease activity and functional status (HAQ).
Main Results:
- The study included 40 children (34 female, 6 male) with a median age of 11.5 years at diagnosis.
- At follow-up, 58.6% of patients had active disease, with 72.5% reporting pain.
- While most patients had good functional outcomes (HAQ 0-1), 22.5% experienced psychological or physical sequelae.
Conclusions:
- The overall clinical outcome for pediatric CRMO is generally favorable.
- A notable proportion of patients experience persistent active disease and pain, suggesting a subset with a severe and prolonged disease course.
- Further research is needed to identify predictors of severe CRMO to guide treatment strategies.
Objective:
To determine the clinical outcome of children with chronic recurrent multifocal osteomyelitis (CRMO).
Methods:
We retrospectively reviewed clinical, biological and radiological data of children with CRMO at five French paediatric centres. Outcome data were obtained through review of hospital charts and questionnaires sent to all patients to assess disease activity and educational and vocational achievement.
Results:
Forty patients were assessed (34 females and 6 males) with a median age at diagnosis of 11.5 yrs (range 2-17). Median number of initial bony lesions was 2 at onset, and 3.5 over disease course. Median time since diagnosis was 3.5 yrs (range 0.5-15) and median duration of active disease 2.7 yrs (range 0.5-13.5). Nine (22.5%) patients had psychological or physical sequelae. Twenty-nine children (72.5%) responded to the questionnaire. Twenty-six had no physical disability as judged by the HAQ 0-1, two had moderate disability (HAQ: 1-2) and one had severe disability (HAQ: 2-3). Seventeen patients (58.6%) had active disease at follow-up (after 6 months to 15 yrs since diagnosis) and continued to have pain (median value of visual analogue scale: 10/100). CRMO had interfered with patient's education in two cases.
Conclusions:
Clinical outcome of children with CRMO is generally good, but a sizeable proportion of patients have active disease at follow-up, and a minority of patients can have a severe and prolonged disease course despite intensive treatments. Further studies are required to determine predictive factors for severe disease.
