Chronic recurrent multifocal osteomyelitis: a rare skeletal disorder

BMJ Case Rep. 2015 Aug 25:2015:bcr2015210061. doi: 10.1136/bcr-2015-210061.

Abstract

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare non-infectious inflammatory bone disease of unknown aetiology. CRMO mainly affects the metaphyses of long bones and spine in children and young adolescents. It presents with recurrent episodes of bone pain and fever, resembling bacterial osteomyelitis, but cultures of lesions are sterile and it is unresponsive to antibiotic therapy. We report a case of a 3-year-old boy diagnosed with CRMO, who was initially treated for bacterial osteomyelitis, and received prolonged antibiotic therapy for chronic pain, and swelling of mandible and ulna. CRMO should be kept in mind in the differential diagnosis of chronic bone pain and osteomyelitis unresponsive to antibiotic treatment.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Bone and Bones / pathology*
  • Child, Preschool
  • Delayed Diagnosis
  • Diagnosis, Differential
  • Etanercept / therapeutic use*
  • Humans
  • Male
  • Mandible / pathology
  • Osteitis / diagnosis*
  • Osteitis / drug therapy
  • Osteitis / etiology
  • Osteomyelitis / diagnosis*
  • Osteomyelitis / drug therapy
  • Osteomyelitis / pathology
  • Rare Diseases
  • Recurrence
  • Ulna / pathology

Substances

  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Etanercept

Supplementary concepts

  • Chronic recurrent multifocal osteomyelitis