scholarly journals Chronic Recurrent Multifocal Osteomyelitis Causing an Acute Scoliosis

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Alexander Armstrong ◽  
Neil Upadhyay ◽  
Edward Saxby ◽  
Damian Pryce ◽  
Nick Steele
Keyword(s):  
Bone Biopsy ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Shoulder Girdle ◽  
Symptomatic Management ◽  
Mri Scans ◽  
History Of ◽  
Multifocal Osteomyelitis ◽  
Atypical Presentations ◽  
Whole Spine ◽  
Bone Condition

Study Design. A Case Report.Objective. We present a 15-year-old girl with an acute atypical scoliosis secondary to chronic recurrent multifocal osteomyelitis (CRMO).Summary of Background Data. CRMO is a rare nonpyogenic inflammatory bone condition with unclear aetiology. CRMO mainly affects the metaphyses of long bones, the pelvis, shoulder girdle, and less commonly the spine.Methods. Our case presented with a 6-month history of worsening thoracic back pain, asymmetry of her shoulders and abnormal posture. Whole spine radiographs revealed a right atypical thoracic scoliosis. Magnetic Resonance Imaging showed abnormal signal on the short TI inversion recovery (STIR) sequences in multiple vertebrae. A bone biopsy demonstrated evidence of fibrosis and chronic inflammatory changes. Interval MRI scans revealed new oedematous lesions and disappearance of old lesions. Symptoms improved.Results. It is important to consider CRMO as an acute cause of atypical scoliosis. Malignancy, pyogenic infections and atypical presentations of juvenile arthritis need excluding.Conclusion. This 24-month follow-up describes a rare cause of an atypical scoliosis and fortifies the small amount of the currently available literature. The case highlights the relapsing and remitting nature of CRMO with new lesions developing and older lesions burning out. We advise close radiological surveillance and symptomatic management.

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):  
Bone Scintigraphy ◽  
Bone Biopsy ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Conventional Radiography ◽  
Radiographic Appearance ◽  
Radiologic Evaluation ◽  
Biopsy Specimens ◽  
Multifocal Osteomyelitis ◽  
Vertebral Bodies ◽  
Bacteria And Fungi

Thirty cases of chronic recurrent multifocal osteomyelitis have been reported in the literature. A radiologic evaluation of thirty-one additional cases, 25 of whom also underwent bone scintigraphy, is presented. Bone biopsy specimens were obtained in 16 patients. Most lesions were located in the metaphyses of the long bones adjacent to the physis and had a characteristic, probably pathognomonic appearance. Extension into the epiphyses was rare. Lesions in the vertebral bodies, clavicle and pelvis had possibly a less specific radiographic appearance. Lesions in short tubular bones were non-specific. Bone scintigraphy had a pratical value in evaluating the global distribution of lesions including asymptomatic lesions and lesions in the spine or pelvis, the latter being somewhat hard to detect with conventional radiography. All biopsies showed acute, subacute or chronic unspecific osteomyelitis, sometimes mixed in the same lesion. Staining for bacteria and fungi was negative.

scholarly journals Clinical and Diagnostic Considerations for Atypical, Adult Onset Presentation of Chronic Recurrent Multifocal Osteomyelitis (CRMO)

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Stacey Mahady ◽  
Amit Ladani
Keyword(s):  
Bone Biopsy ◽  
Delayed Diagnosis ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
The Elderly ◽  
Severe Form ◽  
X Rays ◽  
Elderly Age ◽  
Bony Lesions ◽  
Multifocal Osteomyelitis ◽  
One Year

Chronic recurrent multifocal osteomyelitis (CRMO) is the most severe form of chronic nonbacterial osteomyelitis (CNO) and is a rare autoinflammatory bone disorder that mostly affects children and adolescents. CRMO is a diagnosis of exclusion, resulting in often-delayed diagnosis with over one year on average from onset of symptoms to time of diagnosis. Initial diagnosis is rare in adults and previously undocumented in the elderly (age greater than 65). We highlight a case of a 74-year-old elderly Caucasian female with a history of palmoplantar pustular psoriasis who presented with pelvic and hip pain. Imaging findings included multiple bony lesions on x-rays, increased uptake in the left side of the pelvis, ileum, proximal sternum, and bilateral medial clavicles on nuclear bone scan. Bone biopsy histologic results of marrow fibrosis and plasma cell infiltrate indicative of chronic inflammation lead to the diagnosis of CRMO. This case highlights that while CRMO is typically a disease with childhood onset, it, while rare, can also present in adults and now has presented in the elderly, remaining an important part of the differential diagnosis of bone pain in adults and the elderly in addition to infectious osteomyelitis and malignancy when imaging reveals multiple bony lesions. This in turn will facilitate the reduction of unnecessary medical treatment and antibiotics.

scholarly journals Chronic Recurrent Multifocal Osteomyelitis of the First Metatarsal Bone: A Case Report

2009 ◽  
Vol 17 (1) ◽  
pp. 119-122 ◽  
Author(s):  
CK Chiu ◽  
VA Singh
Keyword(s):  
Case Report ◽  
Symptomatic Relief ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Metatarsal Bone ◽  
First Metatarsal ◽  
History Of ◽  
Multifocal Osteomyelitis ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

We report a case of chronic recurrent multifocal osteomyelitis in a 9-year-old girl. She presented with a 9-month history of gradually worsening pain and swelling in her left foot. Non-steroidal anti-inflammatory drugs were prescribed but the symptoms persisted. She underwent curettage through a small oval corticotomy window on the first metatarsal bone. The pain and swelling improved promptly and she was able to walk without pain 2 weeks later. Curettage enabled rapid symptomatic relief and induced remission, with little risk of complications.

scholarly journals FIRST REPORTED CASE OF MAJEED SYNDROME FROM PAKISTAN

2021 ◽  
Vol 71 (5) ◽  
pp. 1903-05
Author(s):  
Qudrat Ullah Malik ◽  
Asbah Rahman ◽  
Farooq Ikram ◽  
Muhammad Shoaib ◽  
Uzma Akhlaque ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Consanguineous Marriage ◽  
Knee Amputation ◽  
First Case ◽  
The World ◽  
History Of ◽  
Multifocal Osteomyelitis ◽  
History Of Pain ◽  
Hot Weather

Majeed syndrome, characterized by chronic recurrent multifocal osteomyelitis and congenital dyserythropoeitic anemia, is a rare disease reported in children. We report a case of Majeed Syndrome in a 9-year-old boy, born of consanguineous marriage reporting to us for treatment of anemia, requiring blood transfusion. He underwent below-knee-amputation due to unresolving recurrent osteomyelitis at multiple sites. There was history of pain insensitivity and fever during hot weather as well. His interleukin-6 levels were raised. This is the first case of Majeed Syndrome from Pakistan and first in the world with Hereditary Sensory Autonomic Neuropathy type 4 as an associated feature.

scholarly journals 993 Digital Monitoring of Paediatric Patients with Chronic Recurrent Multifocal Osteomyelitis at A National Orthopaedic Centre

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
D Dave ◽  
J Choi ◽  
U Karamchandani ◽  
B Jacobs
Keyword(s):  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Current Treatment ◽  
Online Assessment ◽  
Close Monitoring ◽  
Face To Face ◽  
Response Data ◽  
Frequent Monitoring ◽  
Digital Monitoring ◽  
Multifocal Osteomyelitis ◽  
Bone Condition

Abstract Introduction Chronic recurrent multifocal osteomyelitis (CRMO) is a paediatric inflammatory bone condition requiring close monitoring by a multi-disciplinary team throughout childhood. Many UK patients are seen at the Royal National Orthopaedic Hospital, Stanmore for more than a decade of specialist management. Prior to the recent COVID crisis, we recognised need for more frequent monitoring without the inconvenience of cross-country travel and so piloted an online system of monitoring CRMO. Method An online assessment form was created using the GDPR-compliant Qualtrics system after consultation with CRMO paediatricians and a specialist nurse. 3 medical students telephoned parents of 31 patients to pilot the assessment form. Responses indicating issues were then referred to the CNS for follow-up. Results Response data confirmed need for close monitoring with 26% of respondents being seen quarterly, 29% reporting pain greater than 6/10, 29% having side-effects and 30% finding current treatment ineffective. 74% of respondents found online assessment extremely/very useful and 58% preferred it to face-to-face appointments. Conclusions A digital CRMO monitoring tool can successfully identify patients with both new and ongoing issues. In the COVID and post-COVID era, digital tools can closely monitor patients with chronic conditions like CRMO whilst improving quality of life by reducing need for face-to-face appointments.

Radiographic changes of chronic recurrent multifocal osteomyelitis that persisted into adulthood

2020 ◽  
Vol 13 (7) ◽  
pp. e232106
Author(s):  
Andrew Bergeron ◽  
Thomas Lewellen ◽  
Bhavesh Joshi
Keyword(s):  
Inflammatory Markers ◽  
Proximal Tibia ◽  
Bone Biopsy ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Radiographic Imaging ◽  
Anterior Cortex ◽  
Osteolytic Lesions ◽  
Reactive Protein ◽  
Multifocal Osteomyelitis ◽  
Radiographic Changes

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare non-infectious autoinflammatory disorder typically seen in young women. We describe the case of a young man who presented at 13 years of age with pain in the tibia, humerus, clavicle and hip. Worsening of the condition through clinical presentation and radiographic imaging was observed over 10 years. Radiographic imaging initially showed some sclerotic changes, but worsened to osteolytic lesions of the proximal tibia, elevation of the lateral cortex and thickening of the anterior cortex. Bone biopsy of his right anterior proximal tibia showed no infection or neoplasia. But, laboratory results showed elevation of inflammatory markers such as erythrocyte sedimentation rate or C-reactive protein. The patient was diagnosed with CRMO and treated with antibiotics for suspicion of chronic bacterial osteomyelitis. Chronic bone pain, abnormal imaging and elevation of inflammatory markers suggesting that chronic bacterial osteomyelitis can lead to difficulties with the diagnosis of CRMO.

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

Primary Melanocytoma of the Lower Thoracic Spinal Cord: Case report and review of the literature

2019 ◽  
Vol 8 (1) ◽  
pp. 5
Author(s):  
Dimitrios Panagopoulos
Keyword(s):  
Total Resection ◽  
Thoracic Spinal Cord ◽  
Meningeal Melanocytoma ◽  
Melanocytic Tumors ◽  
Thoracic Spinal ◽  
Thoracolumbar Region ◽  
Rare Benign Tumor ◽  
Mri Scans ◽  
History Of ◽  
The Central Nervous System

Background: Meningeal melanocytoma is a rare benign tumor, most frequently located in the posterior fossa and spinal canal. Our objective is to illustrate a case of this tumor that originated in the thoracolumbar area of the spine and had an uneventful clinical course after total resection. Case description: We present the case of a 59 years old woman who presented with a medical history of ongoing neurological deterioration due to spastic paresis of the lower extremities. MRI of the thoracolumbar region identified a melanocytic melanoma as the underlying cause. Conclusions: Melanocytic tumors of the central nervous system have a typical appearance on MRI scans, varying with the content and distribution of melanin. However, the differential diagnosis between malignant melanoma and melanocytoma still depends on pathological criteria. Spinal meningeal melanocytoma has a benign course, and it is amenable for gross total resection. The outcome is favorable following complete resection.

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