Mind the Localized Skeletal Pain: Chronic Recurrent Multifocal Osteomyelitis

Abstract

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare idiopathic aseptic inflammatory bone disorder affecting primarily children and adolescents characterized by an insidious onset of pain, swelling, and tenderness over the affected bones. The clinical signs and symptoms of CRMO are nonspecific, radiological and histopathological tests are essential for its diagnosis.We present a case of an 18-year-old young man who was diagnosed with CRMO by a combination of clinical data, laboratory results, radiological imaging, and bone biopsy. The patient started anti-inflammatory and immunosuppressant therapy, and his lower extremity pain and swelling improved. This report highlights to investigate promptly in children and adolescents with chronic leg pain, to emphasize the importance of combined clinical, laboratory, and imaging tests for early identification, to have a greater understanding of the imaging appearance and increasing knowledge of this condition, which help shorten time to reach a diagnosis and prevent permanent osseous damage and long-term disabilities.

Clinical features and diagnostic approaches to chronic recurrent multifocal osteomyelitis: A retrospective study

“…Although CRMO is considered a benign disease with an overall good clinical outcome (36,37) , it has also been shown that severe sequelae may occur (38) . According to the literature, patients with CRMO have up to 50% incidence of residual injury (5) and permanent injury or long-term disability can even occur (4,39) , including multiple fractures, skeletal deformities, and severe growth impairment (40) . Therefore, identifying and diagnosing CRMO as early as possible and treating it appropriately and promptly can improve the quality of life of the affected patients and their families.…”

“…Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic nonbacterial osteomyelitis, is an autoin ammatory disease that manifests as recurrent ares of in ammatory bone pain with or without fever (1)(2)(3)(4) . CRMO is an orphan disease with an estimated prevalence of 1-2/1000000 (5) ; however, because the diagnosis of CRMO is challenging and prone to misdiagnosis, the true prevalence of CRMO may be higher (6,7) .…”