Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, CHU Mohammed VI of Marrakech, Marrakech, Morocco.
Pan Afr Med J. 2022 Jun 24;42:150. doi: 10.11604/pamj.2022.42.150.19399. eCollection 2022.
Chronic recurrent multifocal osteomyelitis (CRMO) is an unusual form of non-microbial chronic osteomyelitis. It is an exclusion diagnosis that can only be considered after ruling out infectious osteomyelitis and bone tumors. We report the case of a 13-year-old girl who was admitted for a painful swelling of the left thigh. Biological examinations did not find an inflammatory syndrome. X-rays and Magnetic Resonance Imaging were very suggestive of malignant bone tumor. But the biopsy disclosed a nonspecific osteomyelitis. Considering the strong suspicion of a malignant origin, a second biopsy was performed and confirmed the diagnosis of osteomyelitis. During the hospital stay, the patient developed a second location in the left humerus. Thus, the diagnosis of CRMO was retained. The patient was treated by NSAIDs with good clinical and radiological outcomes. This case report reminds the diagnostic challenge of this pathology that can mimic malignant tumor.
慢性复发性多灶性骨髓炎(CRMO)是一种不常见的非微生物性慢性骨髓炎。它是一种排除性诊断,只有在排除感染性骨髓炎和骨肿瘤后才能考虑。我们报告了一例 13 岁女孩的病例,她因左大腿疼痛肿胀而入院。生物学检查未发现炎症综合征。X 射线和磁共振成像非常提示恶性骨肿瘤。但活检显示非特异性骨髓炎。鉴于对恶性起源的强烈怀疑,进行了第二次活检,确诊为骨髓炎。住院期间,患者左肱骨又出现第二个部位。因此,保留了 CRMO 的诊断。该患者接受非甾体抗炎药治疗,临床和影像学结果良好。本病例报告提醒人们注意这种可能模仿恶性肿瘤的病理学的诊断挑战。