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Chronic recurrent multifocal osteomyelitis in children
TLDR
It has been shown that histological examination alone does not allow the distinction of CRMO from acute or subacute bacterial osteomyelitis, therefore an extensive microbial workup of the tissue biopsy, including PCRtechniques, is essential in order to establish the diagnosis and decide as to the treatment.Abstract:
Chronic recurrent multifocal osteomyelitis (CRMO) in children is an inflammatory disorder. It affects mainly the metaphyses of the long bones, in addition to the spine, the pelvis and the shoulder girdle. However, bone lesions can occur at any site of the skeleton. Even though this disease has been recognized as a clinical entity for almost three decades now, its origin and pathogenesis are not entirely clear. No apparent infectious agents are detectable at the site of the bone lesion. No epidemiological data on incidence and prevalence have been published so far. However, incidence might be something around 1:1,000,000, thus reflecting the number of patients followed-up. Clinical diagnosis in an affected child can be difficult because the clinical picture and course of disease may vary significantly. It has been shown that histological examination alone does not allow the distinction of CRMO from acute or subacute bacterial osteomyelitis. Therefore an extensive microbial workup of the tissue biopsy, including PCRtechniques, is essential in order to establish the diagnosis and decide as to the treatment. Non steroid anti-inflammatory drugs (NSAID) are the treatment of choice. In case of frequent relapses oral steroid treatment, bisphosphonates and azulfidine have been used and are reported to be beneficial.read more
Citations
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Journal ArticleDOI
Chronic non-bacterial osteomyelitis in children
Hermann J. Girschick,P Raab,S Surbaum,A Trusen,S Kirschner,Peter M. Schneider,Thomas Papadopoulos,Hans Konrad Müller-Hermelink,P E Lipsky +8 more
TL;DR: CNO is a spectrum of inflammatory conditions, with CRMO being the most severe, but most children with CNO have a favourable outcome of the disease.
Journal ArticleDOI
Dramatic pain relief and resolution of bone inflammation following pamidronate in 9 pediatric patients with persistent chronic recurrent multifocal osteomyelitis (CRMO)
Paivi Miettunen,Xing-Chang Wei,Deepak Kaura,Walid Abou Reslan,Alberto Nettel Aguirre,James D. Kellner +5 more
TL;DR: Pamidronate resulted in resolution of pain and MRI documented inflammation in all patients and it is proposed that pamidronsate is an effective second-line therapy in persistent CRMO.
Journal ArticleDOI
Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome in childhood: a report of ten cases and review of the literature.
Benedetta C. Beretta-Piccoli,MJ Sauvain,Imre Gal,Andreas Schibler,Traudel Saurenmann,Helene Kressebuch,Mario G. Bianchetti +6 more
TL;DR: The synovitis, acne, pustulosis, hyperostosis, osteitis syndrome is pertinent even in paediatrics since skin involvement is frequent, and in adults, chronic recurrent multifocal osteomyelitis is now a classical manifestation of SAPHO syndrome.
Journal ArticleDOI
Current Understanding of the Pathogenesis and Management of Chronic Recurrent Multifocal Osteomyelitis
Polly J. Ferguson,Monica Sandu +1 more
TL;DR: There is a strong association with inflammatory disorders of the skin and intestinal tract in affected individuals and their close relatives, suggesting a shared pathophysiology and supporting a genetic component to disease susceptibility.
Journal ArticleDOI
Chronic Recurrent Multifocal Osteomyelitis
TL;DR: Non-steroidal anti-inflammatory drugs cause relief of symptoms in the majority of cases and Bisphosphonates and TNF-α blockers are alternatives for patients who do not respond or who have spinal involvement.
References
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Journal Article
Sternoclavicular pustulotic osteitis (SAPHO). 20-year interval between skin and bone lesions.
TL;DR: In 2 cases of palmoplantar pustulosis, a 20-year interval was observed between the skin lesion and the bone involvement, underline the multifaceted presentation of the condition for which the name synovitis acne pustULosis hyperostosis osteitis (SAPHO) syndrome is coined.
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Osseous Manifestations of SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) Syndrome
TL;DR: The histologic findings in SAPHO are variable and nonspecific and may depend on the duration of disease, but it is important to recognize the spectrum of histologic changes possible in the syndrome and to realize that clinicopathologic correlation is necessary to avoid misdiagnosis and unnecessary long-term antibiotic therapy.
Journal ArticleDOI
Chronic osteomyelitislike disease with negative bacterial cultures.
TL;DR: In patients with CRMO, lymphocyte subpopulations, the responses to mitogens, and the chemotactic and chemokinetic responses showed no consistent abnormalities, and after a mean follow-up of 4.5 years all four patients with osteomyelitis of Garré were symptomatic, and two had complications.
Journal ArticleDOI
Chronic recurrent multifocal osteomyelitis: an evolving clinical and radiological spectrum
TL;DR: The unusual clinical and radiological features in patients with chronic recurrent multifocal osteomyelitis suggests that this is a disease that continues to evolve with a broader spectrum of features than recognized.
Journal ArticleDOI
Chronic, Recurrent Multifocal Osteomyelitis Case Report and Review of the Literature
TL;DR: In the proper clinical setting, CRMO should be considered, since recognition of this entity avoids costly and potentially harmful diagnostic and therapeutic interventions.