Symptoma

Chronic Recurrent Multifocal Osteomyelitis

CRMO

They form the basis of this report because of either the unusualness of the clinical presentation, hitherto undescribed associated diseases or the unusual age of presentation and sites of lesions. [ncbi.nlm.nih.gov]

  • Collapse

    The third patient initially had L3 inferior partial collapse and 1 year later T8 involvement with multifocal disease. Follow-up was available over 3 years. [ncbi.nlm.nih.gov]

    When this condition affects the spine it needs to be checked carefully to ensure the spine does not collapse. Opening Hours Monday - Friday: 9.00am - 4.30pm [queenslandrs.com.au]

  • Episodic Course

    Because of its recurrent febrile episodic course, Majeed syndrome should also be included in the differential diagnosis of the periodic fever syndromes. [ncbi.nlm.nih.gov]

  • Recurrent Infection

    Chronic granulomatous disease (CGD) is a primary immunodeficiency that leads to severe recurrent infection and inflammatory complications that are usually difficult to diagnose and treat. [ncbi.nlm.nih.gov]

  • Parotid Mass

    CONCLUSIONS: Parotid mass or swelling is a common presentation of CRMO involving the mandible. The possibility of this diagnosis should be raised when typical clinical and imaging features are present. [ncbi.nlm.nih.gov]

    Parotid swelling and chronic recurrent multifocal osteomyelitis of mandible in children – “Parotid mass or swelling is a common presentation of CRMO involving the mandible.” [saidsupport.org]

  • Musculoskeletal Pain

    OBJECTIVE: Chronic recurrent multifocal osteomyelitis/ chronic non-bacterial osteomyelitis (CRMO/ CNO) is a rare auto-inflammatory disease and typically manifests in terms of musculoskeletal pain. [ncbi.nlm.nih.gov]

    Risk factors for development of non-specific musculoskeletal pain in preteens and early adolescents: a prospective 1-year follow-up study. [doi.org]

  • Arthralgia

    A case of acute lymphotic leukemia which was difficult to make a diagnosis of CRMO for moving arthralgia and periarticular swelling. [saidsupport.org]

  • Shoulder Swelling

    A 13-year-old male presented with a three-year history of recurrent discharging right thigh sinus and an 11-day history of a left shoulder swelling with discharging sinus. [ncbi.nlm.nih.gov]

  • Right Shoulder Pain

    Six months later, this child presented with right shoulder pain and the subsequent imaging demonstrated bilateral clavicular lesions. [ncbi.nlm.nih.gov]

  • Spine Pain

    A 17-year-old man presented with debilitating dorsal spine pain. Magnetic resonance imaging of the spine revealed bone lesions at multiple vertebral levels. After failure of antibiotic treatment, the diagnosis of CRMO was suggested. [ncbi.nlm.nih.gov]

  • Suggestibility

    Two genetic syndromes have CRMO as a prominent phenotype-Majeed syndrome and deficiency of the interleukin-1 receptor antagonist-and suggest that interleukin-1 may be a key cytokine in disease pathogenesis. [ncbi.nlm.nih.gov]

    It is characterized by insidious onset of pain, local bone expansion and radiological findings suggestive of osteomyelitis at multiple sites. CRMO predominantly affects metaphyses of long bones but clavicle and mandible are suggestive of diagnosis. [moh-it.pure.elsevier.com]

  • Confusion

    Both cases were initially confused with other entities, leading to unnecessary initial treatments and a delayed diagnosis. [ncbi.nlm.nih.gov]

    Maksymowych WP (2003) Bisphosphonates for arthritis–a confusing rationale. J Rheumatol 30(3):430–434 PubMed Google Scholar 28. [doi.org]

    […] demonstrated in primary and secondary chronic osteomyelitis, with extensive sclerosis, variable osteolysis and periosteal reaction on diagnostic imaging Osteochemonecrosis of the Jaws Osteoradionecrosis Cemento osseous dyplasia (COD) Has often been confused [pathologyoutlines.com]

[…] description While histological analysis of bone lesions may help to exclude malignant processes, the histologic appearance of CRMO may mimic acute and secondary chronic osteomyelitis caused by microbiological infection Therefore, an extensive microbiological workup [pathologyoutlines.com]

In relation to this case report and our difficulty diagnosing CRMO, we would recommend that whole-body MRI should considered when possible, as part of the diagnostic workup. [em-consulte.com]

  • Microcytosis

    Peripheral blood films showed hypochromia and microcytosis. The sites involved by CRMO were periarticular, mainly around the elbow, knee, wrist and small joints of the hand. [ncbi.nlm.nih.gov]

Goals of treatment of CRMO/CNO include: - Reduce inflammation - Prevent bone damage and bone deformities - Decrease pain CRMO/CNO is different for each patient. Not every child responds to every treatment. [en.wikipedia.org]

To describe an unusual manifestation and treatment of a rare disease. CRMO is a rare inflammatory bone disease that should be differentiated from bacterial osteomyelitis. [ncbi.nlm.nih.gov]

Pain resolution was achieved within 3 months of PAM treatment in every case. One patient subsequently developed a pain amplification syndrome. [doi.org]

Favorable, self-limited long-term prognosis of CRMO has been assumed. Antibiotics provide no improvement. Course, severity and recurrency can be influenced positively by antiphlogistic substances, although this has not yet been proved. [ncbi.nlm.nih.gov]

Prognosis will depend on your child's individual disease and response to treatment. It is best to discuss the prognosis with your child's pediatric rheumatologist. [en.wikipedia.org]

The prognosis can vary among individuals: some children may go into complete remission when they become adults and some may continue with this disease. [checkorphan.org]

Treatment and prognosis CRMO should be treated by a rheumatologist. While non-steroidal anti-inflammatory drugs may cause some symptomatic relief, there is often the need for a greater degree of immunosupression and possibly biological agents. [radiopaedia.org]

Several observations suggest the contribution of genetic factors to the etiology of chronic recurrent multifocal osteomyelitis. [ncbi.nlm.nih.gov]

No epidemiological data on incidence and prevalence have been published so far. However, the incidence might be estimated at 1:1,000,000.The cause of this condition is unknown, despite the intensive investigation over a period of more than 30 years. [medigoo.com]

Eriksen J, Sjøgren P, Bruera E, Ekholm O, Rasmussen NK (2006) Critical issues on opioids in chronic non-cancer pain: An epidemiological study. Pain 125: 172-179. [omicsonline.org]

[…] based on presumed etiology and pathogenesis of disease These criteria are therefore considered a tertiary classification criteria These tertiary criteria help determine the necessary therapeutic strategies which may differ somewhat among the subgroups Epidemiology [pathologyoutlines.com]

Epidemiology of Infectious Disease 12. Epidemiologic Principles 13. Emerging and Reemerging Infectious Disease Threat 14. Bioterrorism: An Overview Section D. Clinical Microbiology 15. The Clinician and the Microbiology Laboratory Section E. [euro-libris.ro]

We summarize the clinical presentation, diagnostic approaches, most recent advances in understanding the pathophysiology, and available treatment options and outcomes in CNO/CRMO. [ncbi.nlm.nih.gov]

Remember, trauma is part of the pathophysiology of this disease. First they bang into something, then they have a transient bacteremia and the bacteria sets up shop in that bone. So, the legs are particularly prone. [lecturio.com]

Hedrich, Chronic Nonbacterial Osteomyelitis: Pathophysiological Concepts and Current Treatment Strategies, The Journal of Rheumatology, 10.3899/jrheum.160256, 43, 11, (1956-1964), (2016). [doi.org]

The case demonstrates to general practitioners and other clinicians that a prolonged administration of antibiotics can be prevented by means of a comprehensive diagnostic procedure for possible bacterial osteomyelitis. [ncbi.nlm.nih.gov]

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