Skip to main content

Advertisement

SpringerLink
Log in

Chronic recurrent multifocal osteomyelitis presenting as acute scoliosis: a case report and review of literature

  • Case Report
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Chronic relapsing multifocal osteomyelitis (CRMO) is a rare condition. It commonly affects the clavicle and pelvis. Rarely it can affect the spine. Spinal deformity due to CRMO is rare. We report a case of acute scoliosis due to CRMO. A 10-year-old girl with CRMO presented with acute painful scoliosis of her spine. She was neurologically intact. Imaging suggested a neoplastic process involving T10, L2 and L3. Further imaging and subsequent biopsy was performed and a diagnosis of CRMO was established. Spinal involvement with deformity is uncommon. It is commonly misdiagnosed as infection or a neoplasm and unnecessary aggressive surgical and antibiotic therapy instituted. A high index of suspicion is needed to diagnose this disease and thus manage it appropriately. This patient with a previously normal spine had a long right sided thoracic scoliosis. We think that the particular pattern of scoliosis was a protective mechanism to offload the right sided T10 vertebral pedicle. Prognosis is generally good although the disease can relapse and remit over many years. At 9 months follow up, the lesions were resolving and the deformity had resolved. CRMO presenting as acute scoliosis is rare and to our knowledge this is the second recognised case in the reported world literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Baulot E, Bouillien D, Giroux EA, Grammont PM (1998) Chronic recurrent multifocal osteomyelitis causing spinal cord compression. Eur Spine J 7(4):340–343

    Article  PubMed  CAS  Google Scholar 

  2. Bjorksten B, Boquist L (1980) Histopathological aspects of chronic recurrent multifocal osteomyelitis. J Bone Joint Surg Br 62(3):376–380

    Google Scholar 

  3. Bjorksten B, Gustavson KH, Eriksson B, Lindholm A, Nordstrom S (1978) Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris. J Pediatr 93(2):227–231

    Article  PubMed  CAS  Google Scholar 

  4. Brand CU, Yawalkar N, Ballmer-Weber B, Braathen LR (1996) Pustulosis palmoplantaris associated with chronic recurrent multifocal osteomyelitis of the mandible. Br J Dermatol 134:977–979

    Article  PubMed  CAS  Google Scholar 

  5. Brown T, Wilkinson RH (1988) Chronic recurrent multifocal osteomyelitis. Radiology 166(2):493–496

    PubMed  CAS  Google Scholar 

  6. Byrd L, Grossmann M, Potter M, Shen-Ong GLC (1991) Chronic multifocal osteomyelitis, a new recessive mutation on chromosome 18 of the mouse. Genomics 11:794–798

    Article  PubMed  CAS  Google Scholar 

  7. Chun CS (2004) Chronic recurrent multifocal osteomyelitis of the spine and mandible: case report and review of the literature. Pediatrics 113(4):e380–e384

    Article  PubMed  Google Scholar 

  8. Coinde E, David L, Cottalorda J et al (2001) Chronic recurrent multifocal osteomyelitis in children: a report of 17 cases [in French]. Arch Pediatr 8:577–583

    Article  PubMed  CAS  Google Scholar 

  9. Cyrlak D, Pais MJ (1986) Chronic recurrent multifocal osteomyelitis. Skeletal Radiol 15(1):32–39

    Article  PubMed  CAS  Google Scholar 

  10. Dawson JS, Webb JK, Preston BJ (1994) Case report: chronic recurrent multifocal osteomyelitis with magnetic resonance imaging. Clin Radiol 49:133–136

    Article  PubMed  CAS  Google Scholar 

  11. Flygare L, Norderyd J, Kubista J, Ohlsson J, Vallo-Christiansen J, Magnusson B (1997) Chronic recurrent multifocal osteomyelitis involving both jaws. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83:300–305

    Article  PubMed  CAS  Google Scholar 

  12. Gamble JG, Rinsky LA (1986) Chronic recurrent multifocal osteomyelitis: a distinct clinical entity. J Pediatr Orthop. 6:579–584

    PubMed  CAS  Google Scholar 

  13. Giedion A, Holthusen W, Masel LF, Vischer D (1972) Subacute and chronic “symmetric osteomyelitis” [in French]. Ann Radiol (Paris) 15:329–342

    CAS  Google Scholar 

  14. Girschick HJ, Krauspe R, Tschammler A, Huppertz HI (1998) Chronic recurrent osteomyelitis with clavicular involvement in children: diagnostic value of different imaging techniques and therapy with non-steroidal antiinflammatory drugs. Eur J Pediatr 157:28–33

    Article  PubMed  CAS  Google Scholar 

  15. Huber AM, Lam PY, Duffy CM, et al (2002) Chronic recurrent multifocal osteomyelitis: clinical outcomes after more than five years of follow-up. J Pediatr 141:198–203

    Article  PubMed  Google Scholar 

  16. Jurik AG (2004) Chronic recurrent multifocal osteomyelitis. Semin Musculoskelet Radiol 8(3):243–253

    Article  PubMed  Google Scholar 

  17. Jurik AG, Egund N (1997) MRI in chronic recurrent multifocal osteomyelitis. Skeletal Radiol 26:230–238

    Article  PubMed  CAS  Google Scholar 

  18. Jurik AG, Helmig O, Ternowitz T, Möller BN (1988) Chronic recurrent multifocal osteomyelitis: a follow-up study. J Pediatr Orthop 8:49–58

    PubMed  CAS  Google Scholar 

  19. King SM, Laxer RM, Manson D, Gold R (1987) Chronic recurrent multifocal osteomyelitis: a noninfectious inflammatory process. Pediatr Infect Dis J 6:907–911

    Article  PubMed  CAS  Google Scholar 

  20. Machiels F, Seynaeve P, Lagey C, Mortelmans LL (1992) Chronic recurrent multifocal osteomyelitis with MR correlation: a case report. Pediatr Radiol 22:535–536

    Article  PubMed  CAS  Google Scholar 

  21. Mandell GA, Contreras SJ, Conard K, Harcke HT, Maas KW (1998) Bone scintigraphy in the detection of chronic recurrent multifocal osteomyelitis. J Nucl Med 39:1778–1783

    PubMed  CAS  Google Scholar 

  22. Manson D, Wilmot DM, King S, Laxer RM (1989) Physeal involvement in chronic recurrent multifocal osteomyelitis. Pediatr Radiol 20:76–79

    Article  PubMed  CAS  Google Scholar 

  23. Martin JC, Desoysa R, O’Sullivan MM, Silverstone E, Williams H (1996) Chronic recurrent multifocal osteomyelitis: spinal involvement and radiological appearances. Br J Rheumatol 35:1019–1021

    Article  PubMed  CAS  Google Scholar 

  24. Paller AS, Pachman L, Rich K, Esterly NB, Gonzalez-Crussi F (1985) Pustulosis palmaris et plantaris: its association with chronic recurrent multifocal osteomyelitis. J Am Acad Dermatol 12(5 Pt 2):927–930

    Article  PubMed  CAS  Google Scholar 

  25. Pelkonen P, Ryoppy S, Jaaskelainen J, Rapola J, Repo H, Kaitila I (1988) Chronic osteomyelitislike disease with negative bacterial cultures. Am J Dis Child 142:1167–1173

    PubMed  CAS  Google Scholar 

  26. Schilling F, Fedlmeier M, Eckardt A, Kessler S. (2002) Vertebral manifestation of chronic recurrent multifocal osteomyelitis (CRMO) [Article in German]. Rofo 174(10):1236–1242

    PubMed  CAS  Google Scholar 

  27. Schilling F, Kessler ST (2001) Chronic recurring multifocal osteomyelitis (CRMO) [in German]. Klin Padiatr 213:271–276

    Article  PubMed  CAS  Google Scholar 

  28. Suei Y, Tanimoto K, Taguchi A et al (1995) Possible identity of diffuse sclerosing osteomyelitis and chronic recurrent multifocal osteomyelitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 80:401–408

    Article  PubMed  CAS  Google Scholar 

  29. Sugimoto H, Tamura K, Fujii T (1998) The SAPHO syndrome: defining the radiographic spectrum of diseases comprising the syndrome. Eur Radiol 8:800–806

    Article  PubMed  CAS  Google Scholar 

  30. Vanhoenacker FM, Baekelandt J, Vanwambeke K, Willemen D, De Schepper AM (1998) Chronic recurrent multifocal osteomyelitis. J Belge Radiol 81(2):84–86

    PubMed  CAS  Google Scholar 

  31. Van Howe RS, Starshak RJ, Chusid MJ (1989) Chronic recurrent multifocal osteomyelitis. Clin Pediatr (Phila) 28:54–59

    Article  Google Scholar 

  32. Yu L, Kasser JR, O’Rourke E, Kozakewich H. (1989) Chronic recurrent multifocal osteomyelitis. Association with vertebra plana. J Bone Joint Surg Am 71(1):105–112

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest statement

None of the authors has any potential conflict of interest.

Author information

Authors and Affiliations

  1. Trauma and Orthopaedics, University Hospital of Wales, Heath Park Avenue, Cardiff, CF14 4XW, UK

    Kedar Deogaonkar, Adel Ghandour, Alwyn Jones, Sashin Ahuja & Kathleen Lyons

Authors
  1. Kedar Deogaonkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adel Ghandour
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alwyn Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sashin Ahuja
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kathleen Lyons
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kedar Deogaonkar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Deogaonkar, K., Ghandour, A., Jones, A. et al. Chronic recurrent multifocal osteomyelitis presenting as acute scoliosis: a case report and review of literature. Eur Spine J 17 (Suppl 2), 248–252 (2008). https://doi.org/10.1007/s00586-007-0516-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-007-0516-6

Keywords

Search

Navigation