The Contributions of Whole-body Magnetic Resonance Imaging for the Diagnosis and Management of Chronic Recurrent Multifocal Osteomyelitis.

TLDR: A notorious characteristic of CRMO appears to be the discrepancy between a frequently underestimated burden of osseous inflammation based on clinical examination, laboratory inflammatory markers, and radiography, and the …

Abstract: A form of the disease today known as chronic recurrent multifocal osteomyelitis (CRMO) was described in 1972 by Giedion, et al as “Subacute and chronic symmetrical osteomyelitis.”1 The authors described the findings of multiple symmetrical lesions in the metaphyses of bone that resembled infectious osteomyelitis; however, no organism could be isolated. More than 40 years later, their initial description, which may be summarized by chronicity, multifocality, symmetry, metaphyseal predilection, and lack of identification of an infectious organ remains remarkably accurate. The condition has been described with a multitude of different names; however, chronic recurrent multifocal osteomyelitis, which is documented as early as 19782, remains commonly used. Although CRMO appears to be diagnosed correctly with increasing frequency, the true prevalence is unknown. This may be due, at least in part, to the variability of clinical presentation. Signs and symptoms may be subtle, inflammatory markers may be normal, and osseous lesions may be clinically undetectable. A notorious characteristic of CRMO appears to be the discrepancy between a frequently underestimated burden of osseous inflammation based on clinical examination, laboratory inflammatory markers, and radiography, and the … Address correspondence to Dr. Fritz. E-mail: jfritz9{at}jhmi.edu