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[慢性复发性多灶性骨髓炎(CRMO)]

[Chronic recurrent multifocal osteomyelitis (CRMO)].

作者信息

Schilling F

机构信息

Klinik für Radiologie, Johannes-Gutenberg-Universität Mainz.

出版信息

Rofo. 1998 Feb;168(2):115-27. doi: 10.1055/s-2007-1015195.

Abstract

Chronic recurrent multifocal osteomyelitis (CRMO) is an unusual clinical entity. More than 200 cases are described in the literature and it is presented here with special reference to its radiological aspects. It is an acquired disease of the skeleton which occurs predominantly during childhood and adolescence. About ten per cent of cases begin in early or, rarely, in later adult life. This variant is described here for the first time and is discussed as "adult CRMO". The underlying pathology is a bland, predominantly lympho-plasma cellular osteomyelitis which is self-limiting and leads to bone sclerosis (Garrè). It probably involves an abnormal immune process which follows an infection but remains clinically latent and remains aseptic and sterile. In a quarter of cases there is an association with pustulosis palmo-plantaris and its relationship with psoriatic arthropathy is discussed. The clinical, histopathological and imaging features (radiological and particularly MRT) and the bone changes are described. This provides a spectrum of symptoms; the radiological differential diagnosis and the relationship with hyperostotic spondyloarthroses during adult life are discussed. The relationship between CRMO, the SAPHO syndrome and acquired hyperostosis syndrome are analysed.

摘要

慢性复发性多灶性骨髓炎(CRMO)是一种罕见的临床病症。文献中描述了200多例病例,本文特别提及了其放射学特征。它是一种骨骼后天性疾病,主要发生在儿童期和青春期。约10%的病例始于成年早期,极少在成年后期发病。这种变体首次在此处描述,并被称为“成人CRMO”进行讨论。其潜在病理是一种温和的、以淋巴细胞 - 浆细胞为主的骨髓炎,具有自限性并导致骨质硬化(加雷氏骨髓炎)。它可能涉及一种异常免疫过程,该过程继发于感染,但在临床上处于潜伏状态,保持无菌和无感染状态。四分之一的病例与掌跖脓疱病有关,并讨论了其与银屑病关节炎的关系。描述了临床、组织病理学和影像学特征(放射学,尤其是磁共振成像)以及骨骼变化。这提供了一系列症状;讨论了放射学鉴别诊断以及与成年期骨质增生性脊椎关节病的关系。分析了CRMO、滑膜炎、痤疮、脓疱病、骨肥厚和骨炎综合征(SAPHO综合征)与后天性骨质增生综合征之间的关系。

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