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Chronic Recurrent Multifocal Osteomyelitis in a Child's Hand: Case Report and Review.
Noemi Harder1, Andreas Woerner2, Alexandre Kaempfen3
1Department of Paediatrics, Children's University Hospital of Basel, Switzerland.
The Journal of Hand Surgery Asian-Pacific Volume
|August 15, 2022
Summary
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare auto-inflammatory disease. This case highlights CRMO affecting the hand, successfully treated with NSAIDs, emphasizing early diagnosis to prevent disability.
Area of Science:
- Pediatric Rheumatology
- Auto-inflammatory Diseases
- Osteomyelitis
Background:
- Chronic recurrent multifocal osteomyelitis (CRMO) is a rare, non-bacterial, osteoarticular inflammatory condition.
- While typically affecting long bones, CRMO can present with atypical manifestations.
- Early diagnosis and management are crucial to prevent long-term sequelae.
Observation:
- A 9-year-old female presented with persistent left wrist pain and swelling.
- Diagnostic workup including X-ray, MRI, and bone biopsy confirmed CRMO.
- The CRMO affected phalangeal and metacarpal bases and distal carpal bones on the ulnar side.
Findings:
- The patient achieved complete remission following treatment with non-steroidal anti-inflammatory drugs (NSAIDs).
- No long-term sequelae were observed after successful treatment.
- This case underscores the possibility of CRMO involvement in the hand, a less common presentation.
Implications:
- Raising awareness of CRMO's potential hand involvement can reduce diagnostic delays.
- Timely diagnosis can prevent unnecessary antibiotic use and potential long-term disability.
- This case contributes to understanding CRMO management in pediatric patients.
