Malek Abdolreza, Aelami Mohammadhassan, Afzali Narges, Parsa Ali, Jalalinia Havva
Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Arch Bone Jt Surg. 2017 May;5(3):196-200.
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare aseptic, auto-inflammatory bone disorder. CRMO presents with bone pain with or without fever. The diagnosis of CRMO is a diagnosis of exclusion and should be included in the differential diagnosis of chronic inflammatory bone lesions in children. Cultures of the bone are typically sterile, antibiotic therapy does not result in clinical improvement whereas anti-inflammatory drugs improve the condition. Furthermore, biopsy should be considered in chronic and relapsing bone pain and swelling unresponsive to treatment. Herein, we present a nine-year-old boy complaining of recurrent pain in his upper and lower extremities. On examination he had mild fever and cervical lymphadenopathy. He also had experienced bone pain and weight loss in the recent month. Based on biopsy and bone scan he was finally diagnosed with CRMO. Naproxen and Pamidronate was prescribed and he was getting better and returned to normal life and activity without need to corticosteroids.
慢性复发性多灶性骨髓炎(CRMO)是一种罕见的无菌性自身炎症性骨病。CRMO表现为伴有或不伴有发热的骨痛。CRMO的诊断是一种排除性诊断,应纳入儿童慢性炎症性骨病变的鉴别诊断中。骨培养通常无菌,抗生素治疗不能带来临床改善,而抗炎药物可改善病情。此外,对于慢性和复发性骨痛以及对治疗无反应的肿胀,应考虑进行活检。在此,我们报告一名9岁男孩,主诉上下肢反复疼痛。检查时,他有低热和颈部淋巴结肿大。他最近一个月还经历了骨痛和体重减轻。基于活检和骨扫描,他最终被诊断为CRMO。给他开了萘普生和帕米膦酸,他的病情好转,恢复了正常生活和活动,无需使用皮质类固醇。