Chronic recurrent multifocal osteomyelitis: clinical outcomes after more than five years of follow-up.
OBJECTIVE
To determine the clinical outcomes of children with chronic recurrent multifocal osteomyelitis (CRMO).


METHODS
Inception cohorts of children with CRMO were established at two tertiary pediatric centers. Outcome data were obtained through review of hospital charts, interview and examination of patients, and completion of questionnaires by patients.


RESULTS
Of 45 eligible subjects, 23 (51%) were assessed. Median time since diagnosis was 13 years (range, 6-25). At evaluation, 6 (26%) had active disease; 18 (78%) had Health Assessment Questionnaire scores of 0 (no/minimal physical disability), and 5 had scores >0. Some impairment was seen in all domains of measurement of quality-of-life test, especially those concerning nonphysical aspects of health. Six (26%) subjects continued to have pain as a result of CRMO. Associated medical problems included arthritis in 6, sacroiliitis in 3, psoriasis in 5, recurrent pustular rashes in 2, and inflammatory bowel disease in 3.


CONCLUSIONS
Long-term clinical outcomes for children with CRMO appear to be generally good, with most subjects having no evidence of disease activity or sequelae. However, a number of subjects had persistent disease and, therefore, remain at risk of physical and psychologic complications. Further research is required to identify patients at risk for persistent disease, and to determine therapies that may prevent morbidity.
Huber
Adam M
AM
IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada. adam.huber@iwk.nshealth.ca
Lam
Pei-Yoong
PY
Duffy
Catherine M
CM
Yeung
Rae S M
RS
Ditchfield
Michael
M
Laxer
Dara
D
Cole
William G
WG
Kerr Graham
H
H
Allen
Roger C
RC
Laxer
Ronald M
RM
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001315:Australia; D001706:Biopsy; D002170:Canada; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D008297:Male; D010019:Osteomyelitis / Q000188:drug therapy / Q000473:pathology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal