Pediatric Orthopedic Department, Kassab Institute, El Manar University, Tunis, Tunisia.
Anatomopathology Department, Kassab Institute, El Manar University, Tunis, Tunisia.
Pan Afr Med J. 2023 Oct 12;46:53. doi: 10.11604/pamj.2023.46.53.39452. eCollection 2023.
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare disease. It is a non-microbial inflammatory bone affection that occurs more often in children with insidious onset and non specific presentation making diagnosis challenging. This study reports a case of CRMO with an unusual location. A 9-year-old child had a painful swelling over the medial side of clavicle with fixed mass. Radiographs showed osteolytic lesion on the medial part of clavicle extending to the acromioclavicular joint with soft tissue edema in magnetic resonance imaging (MRI). No inflammatory markers in biological exam. Needle biopsy, initially performed, suspected bone infection but children didn´t recover after 2 weeks of antibiotics. Surgical biopsy, histology sections were compatible with CRMO diagnosis. Children received a non steroid inflammatory drug with positive response, pain relief and decreasing of the clavicle swelling. CRMO should be suspected and biopsy is some time helpful in such unusual location.
慢性复发性多灶性骨髓炎（CRMO）是一种罕见疾病。它是一种非微生物性炎症性骨病，更多见于儿童，起病隐匿，表现不特异，诊断具有挑战性。本研究报告了一例不常见部位的 CRMO。一名 9 岁儿童出现锁骨内侧疼痛性肿胀伴固定肿块。X 线片显示锁骨内侧部分溶骨性病变，延伸至肩锁关节，伴有磁共振成像（MRI）中的软组织水肿。生物检查中无炎症标志物。最初进行的针吸活检怀疑为骨感染，但儿童在使用抗生素 2 周后并未康复。外科活检的组织学切片符合 CRMO 的诊断。儿童接受了非甾体类抗炎药治疗，反应良好，疼痛缓解，锁骨肿胀减轻。在这种不常见的部位，应怀疑 CRMO 的可能性，有时活检是有帮助的。
