Deden A C, Hissink Muller P, Appelman-Dijkstra N M, Kroon H M, Tramper-Stranders G A
Franciscus locatie Gasthuis, afd. Kindergeneeskunde, Rotterdam.
Ned Tijdschr Geneeskd. 2017;161:D1475.
Osteomyelitis is usually caused by an infection. A non-infectious cause should be considered if antibiotic treatment is insufficiently effective and disease is recurrent, multifocal or migrating.
A 14-year-old girl, an active volleyball player, developed episodes of fever and pain in her right lower leg. MRI showed osteomyelitis in her right tibia. She received prolonged intravenous antibiotic treatment. Shortly after recovery, she developed osteomyelitis in her left lower leg. After exclusion of infection and malignancy, we diagnosed chronic recurrent multifocal osteomyelitis (CRMO). The patient was successfully treated with a NSAID and a bisphosphonate.
CRMO is an auto-inflammatory condition characterised by recurrent, non-infectious, multifocal or migrating osteomyelitis. Patients experience recurrent episodes of bone pain, sometimes accompanied by fever and slightly elevated infection parameters. The disease course usually is self-limiting, without residual damage. Symptomatic treatment with NSAIDs and bisphosphonates often leads to remission.
骨髓炎通常由感染引起。如果抗生素治疗效果不佳且疾病复发、多灶性或游走性发作，则应考虑非感染性病因。
一名14岁的活跃排球运动员女孩，右小腿出现发热和疼痛症状。磁共振成像（MRI）显示其右胫骨患有骨髓炎。她接受了长时间的静脉抗生素治疗。康复后不久，她左小腿又患上了骨髓炎。在排除感染和恶性肿瘤后，我们诊断为慢性复发性多灶性骨髓炎（CRMO）。该患者通过使用非甾体抗炎药（NSAID）和双膦酸盐成功治愈。
CRMO是一种自身炎症性疾病，其特征为复发性、非感染性、多灶性或游走性骨髓炎。患者会反复出现骨痛，有时伴有发热和感染指标略有升高。疾病病程通常为自限性，无残留损害。使用NSAIDs和双膦酸盐进行对症治疗通常可使病情缓解。
