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[Chronic recurrent multifocal osteomyelitis in children]
C Quelquejay1, C Job-Deslandre, A Hamidou
1Service de Radiologie, Hôpital Saint-Vincent-de-Paul, Paris.
Journal De Radiologie
|February 1, 1997
Summary
Chronic multifocal osteomyelitis in children presents diagnostic challenges. Early recognition and biopsy are crucial for accurate diagnosis and management of this condition.
Area of Science:
- Pediatric Rheumatology
- Pediatric Orthopedics
- Medical Imaging
Background:
- Chronic multifocal osteomyelitis (CMO) is a rare condition in children.
- The condition often presents with diagnostic delays due to nonspecific symptoms.
Purpose of the Study:
- To retrospectively analyze clinical, radiological, and histological findings in 10 pediatric CMO cases.
- To highlight diagnostic challenges and emphasize the importance of multimodal diagnostic approaches.
Main Methods:
- Retrospective review of 10 pediatric patients with CMO.
- Utilized plain films, bone scintigraphy, CT/MRI, and histological studies.
- Compared findings with existing literature data.
Main Results:
- Typical radiological findings included initial lytic areas progressing to osteosclerosis.
- Bone scintigraphy consistently showed high uptake, often infraclinical.
- Significant diagnostic delays (3 months to 3 years) were observed.
- Specific features like palmoplantar pustulosis and clavicular lysis were less common than reported.
Conclusions:
- Diagnosis of CMO requires a combination of clinical, biological, and radiological data.
- Histological examination is essential to exclude infectious or tumoral etiologies.
- The pathogenesis of CMO remains unclear, but its association with SAPHO syndrome is recognized.
- Long-term outcomes are uncertain, with persistent symptoms in some patients despite treatment.