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Physeal involvement in chronic recurrent multifocal osteomyelitis
1McMaster University, Department of Radiology, Hamilton, Ontario, Canada.
Abstract:
Chronic recurrent multifocal osteomyelitis is a recently recognized disease characterized by remissions and exacerbations of multiple bone lesions which radiographically and pathologically have the appearance of hematogenous osteomyelitis. No consistent etiology can be identified, and antimicrobial agents seem to have no beneficial effect. A review of the appearances on imaging modalities and the clinical and pathologic manifestations is undertaken in seven cases of CRMO. No therapeutic regimen resulted in consistent clinical or radiographic improvement. We suggest the sequelae of this process are not as benign as previously reported.
Insights
Chronic recurrent multifocal osteomyelitis (CRMO) presents as recurring bone lesions without a clear cause, and antibiotics are ineffective. This study suggests CRMO may have more severe long-term effects than previously understood.
Area of Science:
- Pediatric rheumatology
- Orthopedic pathology
- Medical imaging
Background:
- Chronic recurrent multifocal osteomyelitis (CRMO) is a rare inflammatory bone disorder.
- CRMO mimics infectious osteomyelitis but lacks a definitive etiology.
- Current treatments show limited efficacy.
Purpose of the Study:
- To review imaging findings, clinical presentation, and pathology of CRMO.
- To evaluate treatment responses in CRMO cases.
- To assess the long-term sequelae of CRMO.
Main Methods:
- Retrospective case review of seven CRMO patients.
- Analysis of radiographic and pathological findings.
- Evaluation of clinical and imaging outcomes after various therapeutic regimens.
Main Results:
- CRMO lesions resemble hematogenous osteomyelitis radiographically and pathologically.
- No consistent causative agent was identified.
- Antimicrobial therapy and other treatments did not yield consistent improvement.
Conclusions:
- CRMO is a distinct entity requiring further etiological investigation.
- Treatment strategies for CRMO need re-evaluation.
- The long-term consequences of CRMO may be more significant than previously assumed.