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Chronic Recurrent Multifocal Osteomyelitis Involving the Mandible
Poster Title: Chronic Recurrent Multifocal Osteomyelitis Involving the Mandible
Submitted on 10 Nov 2019
Author(s): Alamoudi, A*; Panneer Selvam, N; Hansen, M; Ruprecht, A; Kashtwari, D
This poster was presented at BIR and AAOMR/IADMFR
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Abstract: Chronic recurrent multifocal osteomyelitis (CRMO) is an aseptic, autoinflammatory condition affecting bone. It is an uncommon entity of uncertain etiology that result in multifocal lesions with pain, swelling, frequent exacerbations and remissions. Clavicle is the most common affected site. Mandibular involvement is considered rare. CRMO can mimic the features of infective osteomyelitis, thus unnecessarily subjecting the patient to a prolonged course of antibiotics, radiation exposure and multiple biopsies. Radiographically, magnetic resonance imaging and bone scintigraphy are the cornerstone for confirming the CRMO lesions. Considering the rarity of this condition, we present the clinical and radiographic features of CRMO in an adolescent male along with a one year follow up. Summary: A 13-year-old male presented with a chief complaint of pain and facial swelling on the left side. His medical history was significant for CRMO and hospitalization for recurrent right facial swelling, tenderness and chronic ankle pain. Extra-oral radiographs depicted a normal bone pattern but mild soft tissue swelling over the left side of the mandible. MRI revealed bone marrow edema in the left mandible, consistent with the known CRMO.References: Monsour PA DJ. Chronic recurrent multifocal osteomyelitis involving the mandible: case reports and review of the literature. Dentomaxillofac Radiol. 2010;39(3):184-190.
2. Giedion A, Holthusen W, Masel LF VD. Subacute and chronic “symmetrical” osteomyelitis. Ann Radiol (Paris). 1972;15(3):329-342.
3. Roderick MR, Sen ES RA. Chronic recurrent multifocal osteomyelitis in children and adults: current understanding and areas for development. Rheumatol (Oxford). 2018;57(1):41-48.
4. Jelušić M, Čekada N, Frković M, Potočki K, Skerlev M, Murat-Sušić S, Husar K, Đapić T, Šmigovec I BD. Chronic Recurrent Multifocal Osteomyelitis (CRMO) and Synovitis Acne Pustulosis Hyperostosis Osteitis (SAPHO) Syndrome - Two Presentations of the Same Disease? Acta Dermatovenerol Croat. 2018;26(3):212-219.
5. Job-Deslandre C, Krebs S KA. Chronic recurrent multifocal osteomyelitis: five-year outcomes in 14 pediatric cases. Jt Bone Spine. 2001;68(3):245-251.
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