Chronic Recurrent Multifocal Osteomyelitis: A Review of 80 Cases in Chinese Children

To analyze the clinical characteristics, treatment approaches, and prognosis of chronic recurrent multifocal osteomyelitis (CRMO) in Chinese pediatric patients.

We conducted a retrospective analysis of 5 cases of CRMO at Children's Hospital Affiliated to Shandong University. These data were compared with the clinical characteristics of 75 pediatric cases reported in China up to December 2024. The medical journal search engines utilized for this study included Wanfang Data and Science China for Chinese literature, while PubMed was employed for foreign language medical journals.

No gender differences were observed in the incidence of CRMO. The diagnostic process may be protracted, with a delay of up to 7 years being observed. A significant majority of patients, specifically 92.5%, presented with bone pain, while fever, arthritis, or rash were noted in 57.5%, 23.8%, and 13.8% of cases, respectively. Laboratory tests conducted on children diagnosed with CRMO indicated elevated levels of C-reactive protein or sedimentation rates. The most frequently affected skeletal sites included the tibia (70.0%), femur (65.0%), fibula (42.5%), foot (36.3%), and pelvis (32.5%).

Clinical manifestations of CRMO in Chinese children are predominantly marked by bone pain and fever, which, due to their nonspecific nature, often lead to delayed diagnosis. Clinicians should closely monitor children presenting with both symptoms to prevent misdiagnosis. In addition, a rigorous long-term follow-up protocol for children with CRMO is essential to accurately evaluate the disease remission rate.