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Chronic recurrent multifocal osteomyelitis

F M Vanhoenacker1, J Baekelandt, K Vanwambeke

  • 1Department of Radiology, Universitair Ziekenhuis Antwerpen, University of Antwerp, Belgium.

Journal Belge De Radiologie
|June 26, 1998
PubMed
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Chronic Recurrent Multifocal Osteomyelitis (CRMO) in a teen presented with scoliosis, pain, and skin lesions. Diagnosis required integrating clinical, radiological, and pathological findings, as bone cultures were negative.

Area of Science:

  • Pediatric Rheumatology
  • Orthopedic Surgery
  • Dermatology

Background:

  • Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a rare, non-bacterial osteomyelitis affecting children and adolescents.
  • Early diagnosis and management are crucial to prevent long-term skeletal deformities and disability.

Observation:

  • A 17-year-old male presented with a 3-month history of antalgic scoliosis, thoracic and sternal pain, low-grade fever, and elevated ESR.
  • Skin manifestations included acne and psoriasis.
  • Radiological imaging revealed osteolytic lesions in the sternum and thoracic spine.

Findings:

  • Histopathological examination of the sternal lesion confirmed chronic osteomyelitis.
  • Bone cultures from the resected specimen were negative for common pathogens.

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  • The diagnosis of CRMO was established by correlating clinical, radiological, histopathological, and microbiological data.

    • Implications:

    • This case highlights the importance of a multidisciplinary approach in diagnosing CRMO, especially when microbiological cultures are unrevealing.
    • Recognizing the diverse clinical presentations of CRMO is essential for timely intervention in pediatric patients.
    • Understanding the diagnostic challenges aids in refining management strategies for this complex condition.