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Chronic recurrent multifocal osteomyelitis (CRMO): a longitudinal case series review
Céline Falip1, Marianne Alison, Nathalie Boutry
1AP-HP, Pediatric Imaging Department, St. Vincent de Paul Hospital, Paris, France.
Pediatric Radiology
|December 25, 2012
Summary
Chronic recurrent multifocal osteomyelitis (CRMO) is a complex autoinflammatory bone disorder. Whole-body MRI effectively detects hidden CRMO lesions, aiding diagnosis and management.
Area of Science:
- Pediatric Rheumatology
- Radiology
- Autoinflammatory Disorders
Background:
- Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disease.
- Diagnosis currently relies on clinical, imaging, pathological, and longitudinal assessments.
Purpose of the Study:
- Describe CRMO lesion patterns on radiography and MRI.
- Evaluate the clinical utility of whole-body MRI.
- Propose a noninvasive diagnostic strategy for CRMO.
Main Methods:
- Retrospective longitudinal study of 31 children diagnosed with CRMO (1989-2010).
- Radiographic and MRI data analyzed by two pediatric radiologists.
Main Results:
- Most common sites: long bone metaphyses (56/108 lesions), pelvis, spine, clavicle, mandible.
- Radiographic findings varied (normal, lytic, sclerotic, mixed); often juxtaphyseal with periosteal thickening.
- MRI revealed medullary edema (42/108 lesions), epiphyseal/soft-tissue inflammation, and juxtiphyseal nodules.
- Whole-body MRI identified subclinical lesions in 15/31 patients.
Conclusions:
- CRMO presents polymorphically, with diverse imaging features.
- Whole-body MRI is crucial for detecting subclinical CRMO-related edema.
- Vertebral CRMO requires long-term monitoring due to potential collapse.
