Imaging of chronic recurrent multifocal osteomyelitis

Area of Science:

• Pediatric Rheumatology
• Pediatric Radiology
• Autoinflammatory Diseases

Background:

• Chronic recurrent multifocal osteomyelitis (CRMO) is a pediatric autoinflammatory disorder.
• It presents as nonbacterial osteomyelitis with recurrent bone pain and inflammation.
• The etiology is unclear, but a genetic component is suspected.

Purpose of the Study:

• To highlight the characteristic imaging findings of CRMO.
• To emphasize the radiologist's role in early diagnosis.
• To guide against unnecessary interventions like biopsies and prolonged antibiotics.

Main Methods:

• Review of typical radiographic and imaging features of CRMO.
• Analysis of disease presentation, distribution, and course.
• Emphasis on differential diagnosis and exclusion criteria.

Main Results:

• CRMO commonly affects long bone metaphyses and medial clavicles, often bilaterally.
• Imaging reveals lytic and sclerotic lesions.
• Diagnosis is often made by exclusion due to lack of a specific test.

Conclusions:

• Radiologists play a key role in suspecting CRMO based on imaging.
• Familiarity with CRMO's radiographic appearance aids in prompt diagnosis.
• Accurate diagnosis prevents invasive procedures and inappropriate antibiotic use.