Chronic recurrent osteomyelitis with clavicular involvement in children: diagnostic value of different imaging techniques and therapy with non-steroidal anti-inflammatory drugs

Abstract

Diagnosis of chronic osteomyelitis of the clavicle should be made by history and physical examination and be confirmed by standard X-ray, bone scan and open biopsy. In contrast MRI and CT can provide data on the involvement of adjacent joints, soft tissue and muscles especially in the early process of disease, but do not add information relevant to the patient's management. Treatment with non-steroidal anti-inflammatory drugs is rapidly beneficial in most patients.

Chronic Recurrent Multifocal Osteomyelitis: Treatment with a Tumor Necrosis Factor-Alpha Inhibitor

“…[12,13] Vertebral compression is a rare radiographic finding, but an MRI revealed compressive lesions of the spine at T 7 -T 9 along with scoliosis in our patient. His pain was lessened after he was treated with NSAIDs.…”

Juvenile Spondyloarthritis

“…Some authors described it as a variant of chronic recurrent multifocal osteomyelitis (CRMO) (Girschick, Krauspe et al 1998), and some as a sternoclavicular syndrome (Kalke, Perera et al 2001). Histopathology is characterized by osteitis, hyperostosis and bone edema, without signs of microorganisms, or evidence of CRMO features.…”

Chronic Non-Bacterial Osteitis/Chronic Recurrent Multifocal Osteomyelitis

“…MRI can detect abnormal bone marrow edema before changes are noted in xray of even bone scintigraphy (Fig.4.) (Girschick, Krauspe et al 1998). Conversely, resolved CRMO is reflected by no signs of inflammation by MRI (Girschick, Raab et al 2005).…”