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Chronic recurrent multifocal osteomyelitis causing an acute scoliosis
Alexander Armstrong1, Neil Upadhyay, Edward Saxby
1Department of Spinal Surgery, Musgrove Park Hospital, Taunton, Somerset TA1 5DA, UK.
Case Reports in Pediatrics
|September 3, 2013
Summary
Chronic recurrent multifocal osteomyelitis (CRMO) can cause acute atypical scoliosis in adolescents. This case report highlights the importance of considering CRMO in differential diagnoses for spinal deformities.
Area of Science:
- Pediatric Orthopedics
- Rheumatology
- Radiology
Background:
- Chronic recurrent multifocal osteomyelitis (CRMO) is a rare, non-pyogenic inflammatory bone disease of unknown cause.
- While typically affecting long bone metaphyses, CRMO can also involve the spine, presenting diagnostic challenges.
Purpose of the Study:
- To report a case of acute atypical scoliosis in a 15-year-old girl secondary to CRMO.
- To emphasize CRMO as a potential cause of spinal deformity in pediatric patients.
Main Methods:
- Clinical presentation of 6-month history of thoracic back pain and postural changes.
- Diagnostic imaging including whole spine radiographs and MRI with STIR sequences.
- Histopathological examination of bone biopsy confirming chronic inflammatory changes.
Main Results:
- Atypical thoracic scoliosis was identified on radiographs.
- MRI revealed multifocal vertebral lesions consistent with CRMO.
- Bone biopsy confirmed chronic inflammation; interval MRIs showed a relapsing-remitting pattern of lesions.
Conclusions:
- CRMO should be considered in the differential diagnosis of acute atypical scoliosis.
- Exclusion of malignancy, infection, and juvenile arthritis is crucial.
- Close radiological surveillance and symptomatic management are recommended for CRMO-related scoliosis.
