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Original Article| Volume 28, ISSUE 2, P438-445, March 2023

Chronic recurrent multifocal osteomyelitis: A multidisciplinary experience of 22 pediatric cases with a mean follow-up of 27 months

Published:December 08, 2021DOI:https://doi.org/10.1016/j.jos.2021.11.009
Chronic recurrent multifocal osteomyelitis: A multidisciplinary experience of 22 pediatric cases with a mean follow-up of 27 months
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      Abstract

      Background

      Chronic recurrent multifocal osteomyelitis (CRMO) is not a well known disorder among nonpediatricians. The aim of this study is to retrospectively evaluate the clinical outcomes of twenty-two CRMO patients presenting to two referral centres.

      Methods

      This retrospective study included twenty-two children (12 males, 10 females; mean age 13 years; range 7–17 years). The diagnosis was based on clinical, radiological, and pathological findings. Data were retrieved from hospital charts.

      Results

      The mean delay in diagnosis was 26 months (range, 0–96 months). The mean follow-up after diagnosis was 27.4 months (range, 6–47 months). Symptoms included pain, limping, local swelling, morning stiffness, and fever. 18 patients had multifocal and 4 patients had unifocal disease. Bone lesions were detected with whole-body or local MRI (Magnetic Resonance Imaging). The mean number of bone lesions was 2.5 (range, 1–8). Ten cases underwent biopsy to exclude malignancy and infection. Prior to diagnosis, cast immobilization or curettage was erroneously performed in four patients. One patient suffered from vertebral compression fracture. There is no growth disturbance or deformity in any patient.

      Conclusion

      This study demonstrated that early recognition of the disease can be improved by using Bristol criteria which should be evaluated by a multidisciplinary team rather than one single specialist. In this way, the reliability of these criteria is improved and the treatment could be given earlier with decreased delay in diagnosis. This multidisciplinary approach is also important for decision for biopsy, timely aggressive medical treatment, and follow-up of the disease to minimise possible complications.
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      Article info

      Publication history

      Published online: December 08, 2021
      Accepted: November 21, 2021
      Received in revised form: October 23, 2021
      Received: August 10, 2021

      Identification

      DOI: https://doi.org/10.1016/j.jos.2021.11.009

      Copyright

      © 2021 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

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