Chronic recurrent multifocal osteomyelitis (CRMO) is a clinical entity distinct from
bacterial osteomyelitis. It occurs mainly in children and adolescents and is characterized
by a prolonged, fluctuating course with recurrent episodes of pain occurring over
several years. CRMO is often multifocal and most often seen in tubular bones, the
clavicle, and less frequently the spine and pelvic bones; other locations are rare.
The radiographic appearance suggests subacute or chronic osteomyelitis. Histopathological
and laboratory findings are nonspecific and bacterial culture is usually negative.
CRMO is often diagnosed by exclusion of the two main differential diagnoses-bacterial
infections and tumor-by assessing for a characteristic course and the findings by
conventional radiography, if necessary supplemented by scintigraphy and/or magnetic
resonance imaging (MRI). The MRI appearance of CRMO lesions in tubular bones and the
spine is often rather characteristic and support the diagnosis. It is important to
diagnose CRMO to avoid unnecessary diagnostic procedures and initiate an appropriate
therapy.
KEYWORDS
Osteomyelitis - chronic - multifocal
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Anne Grethe JurikM.D. D.M.Sc.
Department of Radiology, Aarhus University Hospital, Noerrebrogade 44
DK-8000 Aarhus C, Denmark
