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Chronic Recurrent Multifocal Osteomyelitis
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Chronic recurrent multifocal osteomyelitis (CRMO)
            • Synonyms

              • Chronic nonbacterial osteomyelitis, chronic sclerosing osteomyelitis, condensing osteitis, primary chronic osteomyelitis, pustulotic arthrosteitis, lymphoplasmacellular osteomyelitis
              • Autosomal recessive syndromic form of disease is Majeed syndrome (OMIM# 609628)
            • Definitions

              • Autoinflammatory disorder of bone with fever, multifocal painful nonpyogenic bone lesions, relapsing and remitting course in children and adolescents
              • Adult disease is SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis)
              • Sterile inflammation of bone is hallmark feature

            IMAGING

            • General Features

              • Radiographic Findings

                • MR Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  Selected References

                                  1. Oligbu G et al: The dilemma of chronic recurrent multifocal osteomyelitis. Reumatol Clin. ePub, 2019
                                  2. Jurik AG et al: SAPHO and CRMO: the value of imaging. Semin Musculoskelet Radiol. 22(2):207-24, 2018
                                  3. Hofmann SR et al: Chronic recurrent multifocal osteomyelitis (CRMO): presentation, pathogenesis, and treatment. Curr Osteoporos Rep. 15(6):542-54, 2017
                                  4. Roderick MR et al: Chronic recurrent multifocal osteomyelitis (CRMO) - advancing the diagnosis. Pediatr Rheumatol Online J. 14(1):47, 2016
                                  5. Hedrich CM et al: Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J. 11(1):47, 2013
                                  6. Fritz J et al: Chronic recurrent multifocal osteomyelitis: comparison of whole-body MR imaging with radiography and correlation with clinical and laboratory data. Radiology. 252(3):842-51, 2009
                                  7. Khanna G et al: Imaging of chronic recurrent multifocal osteomyelitis. Radiographics. 29(4):1159-77, 2009
                                  8. Catalano-Pons C et al: Clinical outcome in children with chronic recurrent multifocal osteomyelitis. Rheumatology (Oxford). 47(9):1397-9, 2008
                                  9. Gleeson H et al: Childhood chronic recurrent multifocal osteomyelitis: pamidronate therapy decreases pain and improves vertebral shape. J Rheumatol. 35(4):707-12, 2008
                                  10. Hobolth L et al: Chronic recurrent multifocal osteomyelitis demonstrated by Tc-99m methylene diphosphonate bone scan. Clin Nucl Med. 33(1):61-3, 2008
                                  11. Moll C et al: Ilium osteitis as the main manifestation of the SAPHO syndrome: response to infliximab therapy and review of the literature. Semin Arthritis Rheum. 37(5):299-306, 2008
                                  12. Buck FM et al: Chronic recurrent multifocal osteomyelitis (CRMO) with symmetric involvement of both femora: X-ray, bone scintigram, and MR imaging findings in one case. J Magn Reson Imaging. 26(2):422-6, 2007
                                  13. El-Shanti HI et al: Chronic recurrent multifocal osteomyelitis: a concise review and genetic update. Clin Orthop Relat Res. 462:11-9, 2007
                                  14. Ferguson PJ et al: Autoinflammatory bone disorders. Curr Opin Rheumatol. 19(5):492-8, 2007
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Pathology

                                          • Clinical Issues

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Chronic recurrent multifocal osteomyelitis (CRMO)
                                            • Synonyms

                                              • Chronic nonbacterial osteomyelitis, chronic sclerosing osteomyelitis, condensing osteitis, primary chronic osteomyelitis, pustulotic arthrosteitis, lymphoplasmacellular osteomyelitis
                                              • Autosomal recessive syndromic form of disease is Majeed syndrome (OMIM# 609628)
                                            • Definitions

                                              • Autoinflammatory disorder of bone with fever, multifocal painful nonpyogenic bone lesions, relapsing and remitting course in children and adolescents
                                              • Adult disease is SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis)
                                              • Sterile inflammation of bone is hallmark feature

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • MR Findings

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Staging, Grading, & Classification

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  Selected References

                                                                  1. Oligbu G et al: The dilemma of chronic recurrent multifocal osteomyelitis. Reumatol Clin. ePub, 2019
                                                                  2. Jurik AG et al: SAPHO and CRMO: the value of imaging. Semin Musculoskelet Radiol. 22(2):207-24, 2018
                                                                  3. Hofmann SR et al: Chronic recurrent multifocal osteomyelitis (CRMO): presentation, pathogenesis, and treatment. Curr Osteoporos Rep. 15(6):542-54, 2017
                                                                  4. Roderick MR et al: Chronic recurrent multifocal osteomyelitis (CRMO) - advancing the diagnosis. Pediatr Rheumatol Online J. 14(1):47, 2016
                                                                  5. Hedrich CM et al: Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J. 11(1):47, 2013
                                                                  6. Fritz J et al: Chronic recurrent multifocal osteomyelitis: comparison of whole-body MR imaging with radiography and correlation with clinical and laboratory data. Radiology. 252(3):842-51, 2009
                                                                  7. Khanna G et al: Imaging of chronic recurrent multifocal osteomyelitis. Radiographics. 29(4):1159-77, 2009
                                                                  8. Catalano-Pons C et al: Clinical outcome in children with chronic recurrent multifocal osteomyelitis. Rheumatology (Oxford). 47(9):1397-9, 2008
                                                                  9. Gleeson H et al: Childhood chronic recurrent multifocal osteomyelitis: pamidronate therapy decreases pain and improves vertebral shape. J Rheumatol. 35(4):707-12, 2008
                                                                  10. Hobolth L et al: Chronic recurrent multifocal osteomyelitis demonstrated by Tc-99m methylene diphosphonate bone scan. Clin Nucl Med. 33(1):61-3, 2008
                                                                  11. Moll C et al: Ilium osteitis as the main manifestation of the SAPHO syndrome: response to infliximab therapy and review of the literature. Semin Arthritis Rheum. 37(5):299-306, 2008
                                                                  12. Buck FM et al: Chronic recurrent multifocal osteomyelitis (CRMO) with symmetric involvement of both femora: X-ray, bone scintigram, and MR imaging findings in one case. J Magn Reson Imaging. 26(2):422-6, 2007
                                                                  13. El-Shanti HI et al: Chronic recurrent multifocal osteomyelitis: a concise review and genetic update. Clin Orthop Relat Res. 462:11-9, 2007
                                                                  14. Ferguson PJ et al: Autoinflammatory bone disorders. Curr Opin Rheumatol. 19(5):492-8, 2007