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Chronic recurrent multifocal osteomyelitis

Maria Francesca Gicchino, Mario Diplomatico, Carmela Granato, Daniela Capalbo, Pierluigi Marzuillo, Alma Nunzia Olivieri, Emanuele Miraglia Del Giudice
BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic nonbacterial osteomyelitis, is a rare, noninfectious inflammatory disorder that causes multifocal bone lesions with swelling and pain. Lytic and sclerotic bone lesions could be found on X-ray. Short tau inversion recovery magnetic resonance imaging (STIR MRI) shows bone marrow oedema, bone expansion, lytic areas and periosteal reaction. CRMO is characterized by periodic exacerbations and remissions of unclear/unknown pathogenesis...
February 17, 2018: Italian Journal of Pediatrics
Igor-Moreira Hazboun, Thiago-Pires Brito, Vanessa-Gonçalves Silva, Carlos-Eduardo-Monteiro Zappelini, Leopoldo-Nizam Pfeilsticker
Introduction: SAPHO syndrome is defined as the association of a group of rare sterile osteoarticular disorders and inflammatory skin diseases whose etiology, although not yet determined, probably involves genetic, immunological and infectious mechanisms. The recurrent multifocal osteomyelitis, an inflammatory disease, can be associated with this syndrome even as a single event. Case Report: A case of a young female patient, with a definite diagnosis of SAPHO and an inflammatory mandibular atypical disease for which therapeutic options with immunosuppressants were being used, is reported...
January 2018: Iranian Journal of Otorhinolaryngology
Mikkel Seremet Kofoed, Niels Fisker, Anne Estmann Christensen, Anette Drøhse Kjeldsen
We present two 11-year-old girls with chronic recurrent multifocal osteomyelitis, treated with adalimumab. Both developed severe intracranial complications to sinusitis. Patient 1 had been treated with adalimumab for 15 months when she developed acute sinusitis complicated by an orbital abscess, forehead swelling, a subdural empyema and osteomyelitis of the frontal bone. She was treated with a rhinosurgical and neurosurgical approach with intravenous antibiotics.Patient 2 had been in adalimumab treatment for 10 weeks...
January 17, 2018: BMJ Case Reports
Sigrun Ruth Hofmann, Fanny Böttger, Ursula Range, Christian Lück, Henner Morbach, Hermann Joseph Girschick, Meinolf Suttorp, Christian Michael Hedrich
Objectives: Chronic recurrent multifocal osteomyelitis (CRMO), the most severe form of chronic nonbacterial osteomyelitis (CNO), is an autoinflammatory bone disorder. In the absence of diagnostic criteria or biomarkers, CNO/CRMO remains a diagnosis of exclusion. The aim of this study was to identify biomarkers for diagnosing multifocal disease (CRMO). Study design: Sera from 71 pediatric CRMO patients, 11 patients with osteoarticular infections, 62 patients with juvenile idiopathic arthritis (JIA), 7 patients with para-infectious or reactive arthritis, and 43 patients with acute leukemia or lymphoma, as well as 59 healthy individuals were collected...
2017: Frontiers in Pediatrics
Onengiya Harry, Grant S Schulert, Alexei A Grom, Robert W Frenck, Jon L Woltmann, Andrew H Shapiro, Judith A Smith
No abstract text is available yet for this article.
December 12, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Elena Tronconi, Angela Miniaci, Michelangelo Baldazzi, Laura Greco, Andrea Pession
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare non-infectious inflammatory disorder with unpredictable clinical course, characterized by acute exacerbations and spontaneous remissions. There are no randomized-controlled trials about treatment options. Non-steroidal anti-inflammatory drugs (NSAID) are the first-line treatment option; glucocorticoids seem to be effective; positive outcomes have been obtained with bisphosphonates. In the last few years successful use of biologic agents like anti-TNF agents has been reported...
November 11, 2017: Rheumatology International
Y J Berkowitz, S J Greenwood, G Cribb, K Davies, V N Cassar-Pullicino
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare condition thought to be under-diagnosed, with a true prevalence of more than the 1 in 10,000 estimated. It is a condition that is classically described as polyostotic with a relapsing and remitting course, preferentially affecting the metaphyses of tubular bones in the pediatric population. Lesions have characteristic appearances of cortical hyperostosis and mixed lytic/sclerotic medullary appearances radiographically, with active osteitis and periostitis best seen with fluid-sensitive sequences on magnetic resonance imaging (MRI)...
November 9, 2017: Skeletal Radiology
Yongdong Zhao, Eveline Y Wu, Melissa S Oliver, Ashley M Cooper, Matthew L Basiaga, Sheetal S Vora, Tzielan C Lee, Emily Fox, Gil Amarilyo, Sara M Stern, Jeffrey A Dvergsten, Kathleen A Haines, Kelly A Rouster-Stevens, Karen B Onel, Julie Cherian, Jonathan S Hausmann, Paivi Miettunen, Tania Cellucci, Farzana Nuruzzaman, Angela Taneja, Karyl S Barron, Matthew C Hollander, Sivia K Lapidus, Suzanne C Li, Seza Ozen, Hermann Girschick, Ronald M Laxer, Fatma Dedeoglu, Christian M Hedrich, Polly J Ferguson
OBJECTIVE: To develop standardized treatment regimens for chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis (CRMO) to enable comparative effectiveness treatment studies. METHODS: Virtual and face-to-face discussions and meetings were held within the CNO subgroup of the Childhood Arthritis and Rheumatology Research Alliance (CARRA). A literature search was conducted, and CARRA membership was surveyed to evaluate available treatment data and identify current treatment practices...
November 7, 2017: Arthritis Care & Research
Sigrun R Hofmann, Franz Kapplusch, Hermann J Girschick, Henner Morbach, Jessica Pablik, Polly J Ferguson, Christian M Hedrich
PURPOSE OF REVIEW: Chronic non-bacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disorder. We summarize the clinical presentation, diagnostic approaches, most recent advances in understanding the pathophysiology, and available treatment options and outcomes in CNO/CRMO. RECENT FINDINGS: Though the exact molecular pathophysiology of CNO/CRMO remains somewhat elusive, it appears likely that variable defects in the TLR4/MAPK/inflammasome signaling cascade result in an imbalance between pro- and anti-inflammatory cytokine expressions in monocytes from CNO/CRMO patients...
December 2017: Current Osteoporosis Reports
Adayellen Cristina Salomé Oliveira, Andrew Raimundo Fernandes da Costa, Ana Maria Magalhães Valle Cundari, Vinícius Bicalho Rodrigues
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare idiopathic inflammatory disease that affects mainly children and young adults. The clinical signs and symptoms are nonspecific, hindering and delaying diagnosis. Radiological and histopathological tests are essential for its definition. A case of CRMO is reported, demonstrating the importance of clinical, laboratory, and radiological data for diagnosis.
September 2017: Revista Brasileira de Ortopedia
Catalina Mesa Muñoz, Sara Elena Cardona Correa, Carlos Garcés Samudio, Jaime Toro Uribe
INTRODUCTION: Chronic recurrent multifocal osteomyelitis (CRMO) is a very rare disease, of unknown origin that affects primarily the metaphysis of long bones. It is characterized by an insidious onset of symptoms and multiple remissions. The chronicity of symptoms, the diagnostic imaging and the lack of response to first line antibiotic treatment, should be helpful for diagnostic. OBJECTIVE: Present a clinical case, based on clinical, laboratory, radiologic imaging and histopathological results, that ultimately led to the diagnostic of CRMO...
2017: Revista Chilena de Pediatría
Tiffany A Winstone, Robert D Levy, Kamran Shojania, Darra Murphy, Andrew Churg, Chris Ryerson
Chronic recurrent multifocal osteomyelitis (CRMO) is an idiopathic inflammatory disorder primarily of children and adolescents that is characterized by multifocal nonpyogenic relapsing and remitting inflammatory bone lesions. Pulmonary abnormalities are rarely associated with CRMO, with two reported cases of consolidation on chest CT that occurred in children. We present a case of organizing pneumonia in an adult patient with CRMO. The concurrent worsening of pulmonary and bone disease suggests that CRMO may be a rare cause of organizing pneumonia...
August 2017: Chest
Hiroe Sato, Yoko Wada, Eriko Hasegawa, Yukiko Nozawa, Takeshi Nakatsue, Tomoyuki Ito, Takeshi Kuroda, Takako Saeki, Hajime Umezu, Yoshiki Suzuki, Masaaki Nakano, Ichiei Narita
Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory bone disorder that generally occurs in children and predominantly affects the long bones with marginal sclerosis. We herein report two cases of adult-onset CRMO involving the tibial diaphysis bilaterally, accompanied by polyarthritis. Magnetic resonance imaging (MRI) showed both tibial osteomyelitis and high intensity of the extensive lower leg muscles. Anti-interleukin-6 therapy with tocilizumab (TCZ) effectively controlled symptoms and inflammatory markers in both patients...
September 1, 2017: Internal Medicine
Allison J Cox, Benjamin W Darbro, Ronald M Laxer, Gabriel Velez, Xinyu Bing, Alexis L Finer, Albert Erives, Vinit B Mahajan, Alexander G Bassuk, Polly J Ferguson
[This corrects the article DOI: 10.1371/journal.pone.0169687.].
2017: PloS One
Sigrun Ruth Hofmann, Franz Kapplusch, Katrin Mäbert, Christian Michael Hedrich
Chronic non-bacterial osteomyelitis (CNO) belongs to the growing spectrum of autoinflammatory diseases and primarily affects the skeletal system. Peak onset ranges between 7 and 12 years of age. The clinical spectrum of CNO covers sometimes asymptomatic inflammation of single bones at the one end and chronically active or recurrent multifocal osteitis at the other.Despite the intense scientific efforts, the exact molecular mechanisms of CNO remain unknown. Recent data suggest CNO as a genetically complex disorder with dysregulated TLR4/MAPK/inflammasome signaling cascades resulting in an imbalance between pro- and anti-inflammatory cytokine expression, leading to osteoclast activation and osteolytic lesions...
December 2017: Molecular and Cellular Pediatrics
Renjith Kalathoorakathu Radhakrishnan, Arun Kumar Reddy Gorla, Ashwani Sood, Mahesh Prakash, Anish Bhattacharya, Bhagwant Rai Mittal
No abstract text is available yet for this article.
July 2017: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
A C Deden, P Hissink Muller, N M Appelman-Dijkstra, H M Kroon, G A Tramper-Stranders
BACKGROUND: Osteomyelitis is usually caused by an infection. A non-infectious cause should be considered if antibiotic treatment is insufficiently effective and disease is recurrent, multifocal or migrating. CASE DESCRIPTION: A 14-year-old girl, an active volleyball player, developed episodes of fever and pain in her right lower leg. MRI showed osteomyelitis in her right tibia. She received prolonged intravenous antibiotic treatment. Shortly after recovery, she developed osteomyelitis in her left lower leg...
2017: Nederlands Tijdschrift Voor Geneeskunde
Gabriele Bocchialini, Luca Ferrari, Manuela Rossini, Anna Bozzola, Dante Burlini
INTRODUCTION: Chronic nonbacterial osteomyelitis (CNO) or chronic recurrent multifocal osteomyelitis (CRMO), is a very rare condition of unknown aetiology. It is characterised by focal sterile inflammatory disease with prolonged, self-limiting and recurrent episodes. CASE PRESENTATION: We report the discovery of this very rare disease following a mandibular abscess in a 10-year-old female. We initially focus on the difference between the preoperative orthopantomography and the maxillofacial computed tomography and magnetic resonance images obtained, and then on the improvement of strategies for correct diagnosis and treatment of this disease...
2017: International Journal of Surgery Case Reports
Abdolreza Malek, Mohammadhassan Aelami, Narges Afzali, Ali Parsa, Havva Jalalinia
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare aseptic, auto-inflammatory bone disorder. CRMO presents with bone pain with or without fever. The diagnosis of CRMO is a diagnosis of exclusion and should be included in the differential diagnosis of chronic inflammatory bone lesions in children. Cultures of the bone are typically sterile, antibiotic therapy does not result in clinical improvement whereas anti-inflammatory drugs improve the condition. Furthermore, biopsy should be considered in chronic and relapsing bone pain and swelling unresponsive to treatment...
May 2017: Archives of Bone and Joint Surgery
Miguel Pádua Figueiredo, Marco Pato, Fernando Amaral
INTRODUCTION: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory condition. The clinical picture consists of sterile osteomyelitis, typically with multiple-site lesions in the metaphysis of long bones and not uncommonly, symmetrical bone involvement. It is a poorly understood entity, whose prognosis, etiology and ideal treatment are still controversial. The authors report a case of unifocal presentation with an atypical location. CASE REPORT: A previously healthy 12-year-old Caucasian girl came to our institution due to progressive pain on her left thigh for the previous 3 months...
January 2017: Journal of Orthopaedic Case Reports
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