SAPHO and CRMO: The Value of Imaging

2018 ◽  
Vol 22 (02) ◽  
pp. 207-224 ◽  
Author(s):  
Rikke Klicman ◽  
Paolo Simoni ◽  
Philip Robinson ◽  
James Teh ◽  
Anne Jurik
Keyword(s):  
Interdisciplinary Approach ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Imaging Features ◽  
Invasive Procedures ◽  
Palmoplantar Pustulosis ◽  
Appropriate Treatment ◽  
Pathologic Features ◽  
Skeletal Site ◽  
Characteristic Imaging ◽  
Multifocal Osteomyelitis

AbstractThe syndromes synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) and chronic recurrent multifocal osteomyelitis (CRMO) constitute a group of chronic relapsing inflammatory osteoarticular disorders with frequently associated skin eruptions such as palmoplantar pustulosis and acne conglobata and rather characteristic imaging features in the form of osteitis and/or hyperostosis. CRMO predominantly occurs in children/adolescents and SAPHO in adults. Any skeletal site can be involved, and the imaging appearances vary, depending on the patient's age and the stage/age of the lesion. The diagnosis may be difficult if there is no skin disease, but attention to characteristic imaging appearances may help avoid misdiagnosis (e.g., infection and tumor) and thereby unnecessary invasive procedures as well as facilitating early diagnosis and appropriate treatment. This article provides an overview of the radiologic appearances of SAPHO/CRMO and relevant pathogenetic, clinical, and pathologic features to facilitate the diagnosis that often requires an interdisciplinary approach including radiologists.

Chronic Recurrent Multifocal Osteomyelitis Involving the Mandible – A Rare Case Report

2021 ◽  
Vol 45 (4) ◽  
pp. 273-277
Author(s):  
Abrar Alamoudi ◽  
Niranzena Panneer Selvam ◽  
Deeba Kashtwari ◽  
Axel Ruprecht ◽  
Matthew Hansen
Keyword(s):  
Treatment Plan ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Primary Objective ◽  
Bone Lesions ◽  
Radiographic Appearance ◽  
Appropriate Treatment ◽  
Bone Biopsies ◽  
Rare Case Report ◽  
Multifocal Osteomyelitis ◽  
Autoinflammatory Condition

Chronic recurrent multifocal osteomyelitis (CRMO) is an uncommon, aseptic, autoinflammatory condition characterized by multifocal bone lesions with pain, swelling, and frequent exacerbations and remissions. It is noteworthy that these lesions occur without any identifiable etiology or microbiologic finding. The clavicle and metaphyses of the long bones are often involved whereas involvement of the mandible is considered rare. It is usually diagnosed by exclusion of other diseases. As it shares most of its features with the more commonly occurring infective osteomyelitis, patients are often unnecessarily subjected to prolonged courses of antibiotics, serial radiation exposures, and repeated bone biopsies. We present a case of CRMO involving the mandible. Our primary objective is to demonstrate the clinical features of this uncommon disorder, highlighting the radiographic appearance. Familiarity with this condition among radiologists greatly increases the likelihood for early diagnosis and formulating an appropriate treatment plan.

scholarly journals Non-bacterial osteitis: Chronic Recurrent Multifocal Osteomyelitis or pediatric SAPHO?

2020 ◽  
pp. 26-28
Keyword(s):  
Innate Immunity ◽  
Clinical Features ◽  
Bone Disease ◽  
Bone Pain ◽  
Clinical Presentation ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Sapho Syndrome ◽  
Imaging Features ◽  
Common Clinical Presentation ◽  
Multifocal Osteomyelitis

Chronic Recurrent Multifocal Osteomyelitis (CRMO) and SAPHO syndrome represent the group of autoinflammatory bone disease responsible for recurrent non-bacterial osteitis (NBO). both are considered as defects of innate immunity. The most common clinical presentation is recurrent episodes of bone pain with or without fever.The clinical and imaging features are non-specific.This usually leads to late and confusing diagnosis. We hereby report a case of CRMO in a 12-year-old patient. The aim is to highlight the confusing overlap of clinical features between CRMO and SAPHO syndromes. Keywords: multifocal osteomyelitis, non-bacterial osteitis, SAPHO, bone pain.

scholarly journals SAPHO syndrome with enthesopathy

2019 ◽  
Vol 12 (1) ◽  
pp. e225929 ◽  
Author(s):  
Chin-Fang Su ◽  
Yu-Chuan Shen ◽  
Hsien-Tzung Liao ◽  
Chang-Youh Tsai
Keyword(s):  
Clinical Manifestations ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Sapho Syndrome ◽  
Asian Woman ◽  
Imaging Features ◽  
Middle Aged ◽  
Multifocal Osteomyelitis

Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome was first described as chronic recurrent multifocal osteomyelitis. Because of its rarity, a thorough description of its clinical manifestations is lacking. Herein, we describe the clinical manifestations and imaging features, especially the enthesopathy in bilateral Achilles tendons, of a middle-aged Asian woman with SAPHO syndrome, who improved after diclofenac treatment.

Chronic recurrent multifocal osteomyelitis in children: a new, MRI-based method of quantifying inflammation in the bone

2015 ◽  
Author(s):  
Dionysios Alexandrou ◽  
Benjamin Jacobs ◽  
O'Donnell Paul ◽  
Rikin Hargunani ◽  
Ananya Guha ◽  
...  
Keyword(s):  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Multifocal Osteomyelitis

Chronic recurrent multifocal osteomyelitis in children

1988 ◽  
Vol 29 (5) ◽  
pp. 565-570 ◽  
Author(s):  
W. Mortensson ◽  
G. Edeburn ◽  
M. Fries ◽  
R. Nilsson
Keyword(s):  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Multifocal Osteomyelitis

scholarly journals Patient-reported effectiveness and safety of Pamidronate in NSAIDs-refractory chronic recurrent multifocal osteomyelitis in children

2021 ◽  
Author(s):  
Bartłomiej Juszczak ◽  
Jerzy Sułko
Keyword(s):  
Adverse Drug Reactions ◽  
Social Life ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Daily Activities ◽  
Drug Reactions ◽  
Patient Reported ◽  
Multifocal Osteomyelitis ◽  
Drug Dependent ◽  
Treatment Onset ◽  
The Impact

AbstractTo evaluate patient-reported effectiveness, safety and social influence of Pamidronate in the therapy of NSAIDs-refractory Chronic Recurrent Multifocal Osteomyelitis in children. Authors reviewed self-created questionnaires, which asked patients for symptoms alleviation, adverse drug reactions frequency and degree of severity and daily activities self-reliance. Only surveys with complete answers, which were returned to authors by an e-mail from juvenile patients treated for NSAIDs-refractory Chronic Recurrent Multifocal Osteomyelitis at the University Children’s Hospital of Cracow were analyzed. Between 2010 and 2019, 61 children were diagnosed with NSAIDs-refractory Chronic Recurrent Multifocal Osteomyelitis at our department. Out of 61 requests sent, 42 complete replies (33 females, 9 males) were gathered and analyzed. All patients included in this research were administered with at least one set of Pamidronate intravenously in the dose of 1 mg/kg/day for 3 consecutive days. Our analysis shows remarkable in terms of patient’s impressions decrease of pain intensity after 2.5 series of Pamidronate on average, and total pain resolution after 5.9 series on average. Overall number of adverse drug reaction events reported by responders was 105. One patient developed drug-dependent renal insufficiency in the course of therapy. Outcome assessment indicates that nearly 50% of the studied population was more eager to participate in social life just after the first infusion of the drug. 95% of the surveyed unanimously agreed to recommend Pamidronate therapy to cure NSAIDs-refractory CRMO. 39 out of 42 (93%) patients considered Pamidronate effective at the end of the treatment. Onset of Pamidronate’s action is gradual and differs in terms of symptoms alleviation between sexes. The therapy can induce considerable number of adverse drug reactions (2.5 per patient). Only 3 out of 42 (7%) patients were free from any ADRs. To demonstrate the impact of the use of Pamidronate on daily activities more precisely, further research with quantification of the quality of life is warranted.

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