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Chronic recurrent multifocal osteomyelitis was first described in 1972 and to date 33 cases have been reported, all but one from outside the United States. This unusual osteomyelitis is characteristically recurrent and multifocal with a predilection for the metaphyses. Cultures are persistently negative and antibiotics do not appear to affect the course of the disease, which may be as long as 15 years. Females are affected twice as frequently as males and half the cases are less than ten years old. Antistreptolysin 0 titers are elevated in a quarter of the patients, and there may be a history of previous throat infection. There is an association with pustulosis palmoplantaris. We present two additional cases from the United States.

Telephone follow-up in a recent low-cost ($50) mammography screening project in Orange County, California, was done to determine the detection rate and the induced costs of detection of small breast cancers. Because 403 of 2,261 (18%) women screened required additional evaluation and the cost of evaluation per abnormal mammogram averaged $607, the actual cost per cancer detected was $25,500. At least five cancers were detected per 1,000 women screened, and only 17% of the cancers involved the axillary lymph nodes. The costs of screening mammograms accounted for less than one-third of total costs, with surgical consultations and biopsies for benign disease representing the major induced costs of screening.

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