Chronic Recurrent Multifocal Osteomyelitis - A Case Series from India

Indian J Orthop. 2018 Nov-Dec;52(6):672-677. doi: 10.4103/ortho.IJOrtho_464_17.

Abstract

Background: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare auto-inflammatory disease of the bone. It tends to be multifocal and usually the symptoms tend to run for months and years before diagnosis is usually made. The objective of our study was to understand the clinical presentation and short-term response to treatment of CRMO patients.

Materials and methods: A retrospective analysis of patients diagnosed with CRMO between 2011 and 2016 was done. Case records of these were retrospectively reviewed for clinical features, investigations and treatment received.

Results: Six patients were diagnosed with CRMO. The median age of onset and time to diagnosis from onset of symptoms was 8 and 3.5 years respectively. Lower limb bones were the most commonly involved.

Conclusions: There is significant delay in diagnosis of CRMO and this could be because of a lack of awareness of this condition amongst clinicians. Our case series with only male affection is rather unique as compared to other case series reported in medical literature which tend to have more female predilection. Pain with or without swelling was the most common symptom. Most of patients responded to combination therapy.

Keywords: Chronic recurrent multifocal osteomyelitis; Osteomyelitis; analgesics; chronic disease; etanercept; majeed syndrome; nonsteroidal anti-inflammatory drugs; pamidronate.