Watanabe Toru, Ono Hiroyuki, Morimoto Yoshitaka, Otsuki Yoshiro, Shirai Masami, Endoh Akira, Naito Masaaki, Inoue Yoshiya, Hongo Teruaki
Department of Pediatrics, Iwata City Hospital, Iwata, Japan.
Department of Orthopedics, Iwata City Hospital, Iwata, Japan.
Nagoya J Med Sci. 2015 Aug;77(3):493-500.
An 11-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis (CRMO) and presented with right sacro-femoral and occipital lesions. Initially, a tumor was suspected. However, the bone biopsy showed osteomyelitis with a negative bacterial culture. Bone scintigraphy revealed inflammatory changes on multiple bone lesions. The slight elevation in inflammatory markers such as C-reactive protein was of little clinical value. He was diagnosed with CRMO by sacral biopsy, and the clinical course progressed, with the presence of a new occipital lesion observed after the 1-year follow-up. The administration of non-steroidal anti-inflammatory drugs successfully improved his clinical symptoms. The presence of a skull lesion in the occipital bone of a pediatric patient with CRMO has not been previously reported.
一名11岁男孩被诊断为慢性复发性多灶性骨髓炎（CRMO），并出现右骶股和枕部病变。最初怀疑是肿瘤。然而，骨活检显示为骨髓炎，细菌培养呈阴性。骨闪烁显像显示多个骨病变有炎症改变。炎症标志物如C反应蛋白轻度升高，临床价值不大。通过骶骨活检诊断为CRMO，临床病程进展，1年随访后发现有新的枕部病变。非甾体抗炎药的使用成功改善了他的临床症状。此前尚未有CRMO小儿患者枕骨出现颅骨病变的报道。
