Jibril Huzefa, Riaz Mehmood, Ali Syed Ahsan
Dr. Huzefa Jibril, MBBS. Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
Dr. Mehmood Riaz, FCPS. Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
Pak J Med Sci. 2024 Sep;40(8):1889-1891. doi: 10.12669/pjms.40.8.8765.
Chronic recurrent multifocal osteomyelitis is a rare autoimmune disorder causing inflammatory joint lesions. It has an estimated prevalence of 1-2 per million while adult-onset disease constitutes only 6.3% of patients.
We present a case of a 44 years old male who presented to the rheumatology clinic with lower back pain for twelve years. Magnetic resonance imaging of the lumbosacral spine showed ovoid areas of abnormal signal intensities along superior and inferior endplates of multiple vertebrae of the dorsolumbar and sacral spine. Computed tomography guided biopsy of L4 vertebrae was done. Histopathology revealed linear cores of degenerating fibrocartilage focally exhibiting small spicules of mineralized bone and fibro-collagenous tissue. He initially did not respond to traditional therapy. His symptoms improved with the addition of a Janus Kinase inhibitor. To the best of our knowledge, this is the first case of chronic recurrent multifocal osteomyelitis to be reported from Pakistan.
慢性复发性多灶性骨髓炎是一种罕见的自身免疫性疾病，可导致炎症性关节病变。其估计患病率为百万分之一至二，而成人发病的疾病仅占患者的6.3%。
我们报告一例44岁男性，因下背部疼痛12年就诊于风湿病诊所。腰骶部脊柱磁共振成像显示，胸腰椎和骶椎多个椎体的上下终板处有椭圆形异常信号区。对L4椎体进行了计算机断层扫描引导下的活检。组织病理学显示，退化的纤维软骨线性核心局部可见矿化骨小刺和纤维胶原组织。他最初对传统治疗无反应。加用一种 Janus 激酶抑制剂后症状改善。据我们所知，这是巴基斯坦报告的首例慢性复发性多灶性骨髓炎病例。
