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Radiological diagnosis of chronic recurrent multifocal osteomyelitis using whole-body MRI-based lesion distribution
S Andronikou1, T Mendes da Costa2, M Hussien2
1Department of Paediatric Radiology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol BS2 8BJ, UK; Department of Pediatric Radiology, the Children's Hospital of Philadelphia, Civic Center Boulevard, Philadelphia, USA.
Clinical Radiology
|July 9, 2019
Summary
Chronic recurrent multifocal osteomyelitis (CRMO) often presents as multifocal bone lesions, frequently in the tibia. Whole-body MRI reveals distinct patterns, including predominantly tibial or clavicular/spinal involvement.
Area of Science:
- Pediatric rheumatology
- Pediatric orthopedics
- Medical imaging
Background:
- Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory bone disorder affecting children.
- Understanding CRMO's distribution is crucial for diagnosis and management.
Purpose of the Study:
- To characterize the distribution patterns and extent of CRMO lesions using whole-body magnetic resonance imaging (WBMRI).
Main Methods:
- Retrospective review of WBMRI scans from 37 children diagnosed with CRMO.
- Utilized a novel pictorial mapping system to assess lesion load and distribution by three radiologists.
Main Results:
- Identified 317 lesions across 37 patients, with 89% exhibiting multifocal involvement.
- The tibia was the most commonly affected bone (68%), followed by the clavicle (38%) and spine (19%).
- Two predominant patterns emerged: multifocal tibial involvement (54%) and pauci-focal clavicular/spinal disease (24%).
Conclusions:
- CRMO lesions are typically multifocal with characteristic distal metaphyseal locations in long bones.
- Distinct phenotypic patterns of CRMO, primarily tibial or clavicular/spinal, were identified.
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