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Chronic recurrent multifocal osteomyelitis (CRMO): a longitudinal case series review

Authors
  • Falip, Céline1
  • Alison, Marianne2, 3
  • Boutry, Nathalie4, 5
  • Job-Deslandre, Chantal6
  • Cotten, Anne4, 7
  • Azoulay, Robin3
  • Adamsbaum, Catherine8, 9
  • 1 St. Vincent de Paul Hospital, AP-HP, Pediatric Imaging Department, Paris, France , Paris (France)
  • 2 Paris Diderot University, Faculty of Medicine, Paris, France , Paris (France)
  • 3 Robert Debré Hospital, AP-HP, Pediatric Imaging Department, Paris, France , Paris (France)
  • 4 Lille 2 University, Faculty of Medicine, Lille, France , Lille (France)
  • 5 Jeanne de Flandre Hospital, Pediatric Imaging Department, Lille, France , Lille (France)
  • 6 Cochin Hospital, AP-HP, Rhumatology Department, Paris, France , Paris (France)
  • 7 Roger Salengro Hospital, Musculoskeletal Radiology Department, Lille, France , Lille (France)
  • 8 Paris Sud University, Faculty of Medicine, Le Kremlin Bicêtre, France , Le Kremlin Bicêtre (France)
  • 9 Bicêtre Hospital, AP-HP, Pediatric Imaging Department, 78 rue du Gal Leclerc, Le Kremlin Bicêtre Cedex, 94275, France , Le Kremlin Bicêtre Cedex (France)
Type
Published Article
Journal
Pediatric Radiology
Publisher
Springer-Verlag
Publication Date
Dec 22, 2012
Volume
43
Issue
3
Pages
355–375
Identifiers
DOI: 10.1007/s00247-012-2544-6
Source
Springer Nature
Keywords
License
Yellow

Abstract

BackgroundChronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disorder that is currently diagnosed based on clinical, radiologic, pathological and longitudinal findings.ObjectiveTo provide detailed descriptions of CRMO lesion patterns seen on radiographs and MRI and to suggest clinical use of whole-body MRI and propose noninvasive diagnostic strategy.Materials and methodsRetrospective longitudinal study (1989–2010) of 31 children (22 girls, 9 boys) diagnosed with CRMO. Imaging data were evaluated by two pediatric radiologists.ResultsMean age at diagnosis was 11 years (3–17). A total of 108 lesions were investigated. The most common sites were the long bone metaphyses (56 lesions in 24 children) especially femoral and tibial (20/24); pelvis (10/31); spine (9/31); clavicle (6/31) and mandible (3/31). In long bones, the radiologic appearance was normal (22/56), mixed lytic and sclerotic (20/56), sclerotic (8/56) or lytic (6/56) often juxtaphyseal (36/56), with hyperostosis or periosteal thickening (10/56). Vertebral involvement was often multifocal (6/9). Medullary edema was seen on MRI (42) with epiphyseal (23/42) or soft-tissue (22/42) inflammation and juxtaphyseal nodule-like appearance (7/42). Whole-body MRI (15/31) was key in detecting subclinical lesions.ConclusionCRMO is a polymorphous disorder in which whole-body MRI is extremely useful for showing subclinical edema. Vertebral collapse requires long-term monitoring.

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