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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

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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:

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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.