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Skeletal Radiology

, Volume 25, Issue 4, pp 333–336 | Cite as

Chronic recurrent multifocal osteomyelitis: an evolving clinical and radiological spectrum

  • M. Sundaram
  • Douglas McDonald
  • Elizabeth Engel
  • Mitchell Rotman
  • Elaine C. Siegfried
ARTICLE

Abstract

Objective. To describe unusual clinical and radiological features in patients with chronic recurrent multifocal osteomyelitis (CRMO). Design and subjects. Based on radiographic and microscopic findings, three patients were prospectively diagnosed as having chronic recurrent multifocal osteomyelitis (CRMO). They form the basis of this report because of either the unusualness of the clinical presentation, hitherto undescribed associated diseases or the unusual age of presentation and sites of lesions. Results. One patient developed pyoderma gangrenosum at the site of one of the skeletal lesions and then went on to develop ulcerative proctitis. A second patient presented with a soft tissue mass, which on MRI mimicked a sarcoma. The final patient presented with lesions in the wrist and phalanges of the toes at the unusual age of 38. None of the patients was treated with steroids or antibiotics for the skeletal lesions. Steroids were administered to one patient for treatment of pyoderma gangrenosum. Conclusions. The pattern and distribution of skeletal lesions in CRMO are well recognized in the pediatric age group. The unusual clinical and/or radiological features discussed herein suggests that this is a disease that continues to evolve with a broader spectrum of features than recognized.

Key words Chronic recurrent multifocal osteomyelitis Pyoderma gangrenosum Ulcerative proctitis Soft tissue mass Adult female Expectant treatment 

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Copyright information

© International Skeletal Society 1996

Authors and Affiliations

  • M. Sundaram
    • 1
  • Douglas McDonald
    • 2
  • Elizabeth Engel
    • 2
  • Mitchell Rotman
    • 2
  • Elaine C. Siegfried
    • 3
  1. 1.Department of Radiology, St. Louis University Medical Center, 3635 Vista at Grand, St. Louis, MO 63110-0250, USAUS
  2. 2.Department of Orthopedic Surgery, St. Louis University Medical Center, St. Louis, Missouri, USAUS
  3. 3.Department of Internal Medicine/ Dermatology Division, St. Louis University Medical Center, St. Louis, Missouri, USAUS

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