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Case Reports
. 2019 Dec 25;54(4):272-276.
doi: 10.14744/TurkPediatriArs.2018.69379. eCollection 2019.

Chronic recurrent multifocal osteomyelitis: a case report

Esma Altınel Açoğlu  1 , Meltem Akçaboy  1 , Yasemin Taşçı Yıldız  2 , Nedim C M Gülaldı  3 , Eyüp Sarı  1 , Pelin Zorlu  1 , Saliha Şenel  1
Affiliations
Case Reports

Chronic recurrent multifocal osteomyelitis: a case report

Esma Altınel Açoğlu et al. Turk Pediatri Ars. .

Abstract
in English, Turkish

Chronic recurrent multifocal osteomyelitis is a rare autoinflammatory, immunologic disorder. It may involve recurrent inflammatory bone pain associated with aseptic osteomyelitis. If the diagnosis is delayed, it negatively influences quality of life by leading to persistent symptoms or joint damage. Herein, we report a 16-year-old male patient who presented with left hip and right knee pain lasting for the last two months and was diagnosed as having chronic recurrent multifocal osteomyelitis as a result of further evaluation. Improvement was achieved with prednisolone and methotrexate treatment that was initiated when no response to ibuprofen treatment could be obtained. Chronic recurrent multifocal osteomyelitis must be considered in the differential diagnosis in patients presenting with joint symptoms when clinical and radiologic bone lesions are found, no microorganism growth is observed, and no response to antibiotic treatment is obtained.

Kronik rekürren multifokal osteomyelit nadir görülen, otoinflamatuvar, immün bozukluktur. Aseptik osteomiyelitle ilişkili tekrarlayan inflamatuvar kemik ağrıları ile seyredebilmektedir. Tanı gecikmesi durumunda persistan bulgulara ya da eklem hasarına neden olarak hayat kalitesini olumsuz etkilemektedir. Burada iki aydır olan sol kalça ve sağ diz ağrısı ile başvuran ve ileri değerlendirme sonucu kronik rekürren multifokal osteomyelit tanısı alan 16 yaşında erkek hasta sunulmuştur. İbuprofen tedavisine yanıt alınamaması üzerine başlanan prednisolon ve metotreksat tedavileri ile iyileşme sağlanmıştır. Eklem yakınmaları ile başvuran hastalarda, klinik ve radyolojik olarak kemik lezyonlarının saptanması halinde, herhangi bir mikroorganizma üretilememesi ve antibiyotik tedavisine yanıt alınamaması durumunda ayırıcı tanıda kronik rekürren multifokal osteomiyelit mutlaka düşünülmelidir.

Keywords: Arthralgia; arthritis; chronic recurrent multifocal osteomyelitis.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Appearance of sclerosis in bilateral acetabular rooves on hip radigraphy
Figure 2
Figure 2
Early screening and static whole-body bone scintigraphy (Tc99m-MDP)
Figure 3
Figure 3
(a) Anterior pelvis static bone scintigraphy. Increased activity uptake compared to its symmetrics in the medial part of the right superior ramus pubis and in the epiphyseal line in the right trochanter major. (b) Lateral static bone scintigraphy of both feet. Increased activity accumulation in the left calcaneal epiphyseal line compared to its symmetrics
See this image and copyright information in PMC

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