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Lymphoplasmacellular osteomyelitis.

R Krauspe1, H Girschick2, H I Huppertz2

  • 1Orthopädische Klinik, König-Ludwig-Haus, Julius-Maximilians-Universität Würzburg, Germany.

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PubMed
Summary
This summary is machine-generated.

Chronic lymphoplasmacellular osteomyelitis, often presenting as SAPHO syndrome, is a rare bone infection typically affecting children and adults. Diagnosis requires a combination of clinical, radiological, and histological findings with negative cultures, and it responds well to NSAIDs.

Keywords:
Key words Lymphoplasmacellular osteomyelitis • Chronic recurrent multifocal osteomyelitis • SAPHO syndrome

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Area of Science:

  • Orthopedics
  • Rheumatology
  • Pathology

Background:

  • Chronic lymphoplasmacellular osteomyelitis is a rare condition affecting children, adolescents, and adults, characterized by a chronic course with periods of symptoms and remission.
  • It is distinct from acute osteomyelitis and typically presents with pain and swelling, commonly affecting the clavicle and long bones in younger individuals, and clavicles/ribs in adults.

Purpose of the Study:

  • To provide a comprehensive overview of chronic lymphoplasmacellular osteomyelitis, including its clinical presentation, diagnostic methods, and treatment outcomes.
  • To highlight the association with SAPHO syndrome and differentiate it from bacterial osteomyelitis.

Main Methods:

  • Review of clinical, radiological (X-ray, bone scan, MRI), and histological findings in patients with chronic lymphoplasmacellular osteomyelitis.
  • Analysis of laboratory data, including inflammatory markers, and bacteriological cultures.
  • Correlation of findings with the diagnostic criteria for SAPHO syndrome.

Main Results:

  • The condition is characterized by non-specific laboratory findings (elevated ESR/CRP) and varied radiological presentations (osteolytic, sclerotic changes, periosteal reactions).
  • Histology shows lymphocytic and plasmacellular infiltrates, distinguishing it from early-stage bacterial osteomyelitis.
  • SAPHO syndrome encompasses synovitis, acne, pustulosis, hyperostosis, and osteomyelitis, with potential skin and joint manifestations preceding or following bone involvement.

Conclusions:

  • Definitive diagnosis of chronic lymphoplasmacellular osteomyelitis relies on integrating clinical, radiological, histological evidence, and negative bacteriological cultures.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) are effective for symptom management; antibiotics and major surgery are generally not recommended.
  • The long-term prognosis for growth and function is excellent, despite potential recurrences.