Service de rhumatologie A, Université Paris Descartes, AP-HP, hôpital Cochin, Paris, France.
Joint Bone Spine. 2011 Dec;78(6):555-60. doi: 10.1016/j.jbspin.2011.02.010. Epub 2011 Mar 26.
Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic nonbacterial osteomyelitis, is an orphan disease that manifests as recurrent flares of inflammatory bone pain with or without a fever. The pain is related to one or more foci of nonbacterial osteomyelitis. To distinguish unifocal CRMO from a tumor or an infection, a bone biopsy is required in nearly all patients and a trial of antibiotic therapy in many. CRMO is now considered the pediatric equivalent of SAPHO syndrome, and recent data suggest that CRMO should be classified among the autoinflammatory diseases. The treatment of CRMO is not standardized. Although no randomized placebo-controlled trials are available, there is general agreement that nonsteroidal antiinflammatory drugs constitute the best first-line treatment and that bisphosphonates and biotherapies such as TNFα antagonists are effective in the most severe forms. Although CRMO is considered a benign disease, recent data suggest an up to 50% rate of residual impairments despite optimal management.
慢性复发性多灶性骨髓炎（CRMO），又称慢性非细菌性骨髓炎，是一种孤儿病，表现为炎症性骨痛反复发作，可伴或不伴发热。疼痛与一个或多个非细菌性骨髓炎病灶有关。为了将单发 CRMO 与肿瘤或感染区分开来，几乎所有患者都需要进行骨活检，许多患者需要进行抗生素治疗试验。CRMO 现在被认为是 SAPHO 综合征的儿科等效物，最近的数据表明 CRMO 应归类于自身炎症性疾病。CRMO 的治疗尚未标准化。尽管没有随机安慰剂对照试验，但人们普遍认为非甾体抗炎药是最佳的一线治疗药物，双膦酸盐和 TNFα 拮抗剂等生物疗法对最严重的形式有效。尽管 CRMO 被认为是一种良性疾病，但最近的数据表明，即使进行了最佳治疗，仍有高达 50%的患者存在残留损伤。
