Quon Jeffrey S, Dzus Anne K, Leswick David A
Department of Medical Imaging, Ottawa Hospital, University of Ottawa, Civic Campus, Ottawa, ON, Canada K1N 6N5.
Case Rep Radiol. 2012;2012:515761. doi: 10.1155/2012/515761. Epub 2012 Feb 28.
Chronic recurrent multifocal osteomyelitis (CRMO) is relatively uncommon. Even though the name suggests it is the result of infection, this is not likely the case. Instead it is more likely the result of genetic, autoimmune, or autoinflammatory causes. Although CRMO has a benign course and responds well to anti-inflammatory medications, it can have a very aggressive clinical and imaging presentation overlapping with infectious osteomyelitis and malignancy. Therefore, radiologists and clinicians need to be aware of its clinical and imaging presentation to avoid morbidity associated with more aggressive treatment. We present the case of a ten-year-old female with CRMO as a solitary expansile-mixed lytic and sclerotic lesion in the distal femoral diaphysis. The diaphyseal location and mixed lytic and sclerotic appearance are less common and have an aggressive imaging appearance. We also review the pathophysiology, imaging findings, and therapeutic approach to this uncommon but clinically important condition.
慢性复发性多灶性骨髓炎（CRMO）相对少见。尽管其名称暗示它是感染的结果，但情况可能并非如此。相反，它更可能是遗传、自身免疫或自身炎症原因导致的。虽然CRMO病程良性，对抗炎药物反应良好，但它可能具有与感染性骨髓炎和恶性肿瘤重叠的非常侵袭性的临床和影像学表现。因此，放射科医生和临床医生需要了解其临床和影像学表现，以避免与更积极治疗相关的发病率。我们报告一例10岁女性CRMO病例，表现为股骨干远端的孤立性膨胀性溶骨性和硬化性混合病变。骨干部位以及溶骨性和硬化性混合表现较为少见，且具有侵袭性的影像学表现。我们还回顾了这种罕见但临床重要疾病的病理生理学、影像学表现及治疗方法。
