title: Chronic recurrent multifocal osteomyelitis (CRMO): a longitudinal case series review.
abstract: BACKGROUND
  Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disorder that is currently diagnosed based on clinical, radiologic, pathological and longitudinal findings.
  
  
  OBJECTIVE
  To provide detailed descriptions of CRMO lesion patterns seen on radiographs and MRI and to suggest clinical use of whole-body MRI and propose noninvasive diagnostic strategy.
  
  
  METHODS
  Retrospective longitudinal study (1989-2010) of 31 children (22 girls, 9 boys) diagnosed with CRMO. Imaging data were evaluated by two pediatric radiologists.
  
  
  RESULTS
  Mean age at diagnosis was 11 years (3-17). A total of 108 lesions were investigated. The most common sites were the long bone metaphyses (56 lesions in 24 children) especially femoral and tibial (20/24); pelvis (10/31); spine (9/31); clavicle (6/31) and mandible (3/31). In long bones, the radiologic appearance was normal (22/56), mixed lytic and sclerotic (20/56), sclerotic (8/56) or lytic (6/56) often juxtaphyseal (36/56), with hyperostosis or periosteal thickening (10/56). Vertebral involvement was often multifocal (6/9). Medullary edema was seen on MRI (42) with epiphyseal (23/42) or soft-tissue (22/42) inflammation and juxtaphyseal nodule-like appearance (7/42). Whole-body MRI (15/31) was key in detecting subclinical lesions.
  
  
  CONCLUSIONS
  CRMO is a polymorphous disorder in which whole-body MRI is extremely useful for showing subclinical edema. Vertebral collapse requires long-term monitoring.
authors.affiliation: AP-HP, Pediatric Imaging Department, St. Vincent de Paul Hospital, Paris, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Falip
authors.forename: Marianne
authors.initials: M
authors.lastname: Alison
authors.forename: Nathalie
authors.initials: N
authors.lastname: Boutry
authors.forename: Chantal
authors.initials: C
authors.lastname: Job-Deslandre
authors.forename: Anne
authors.initials: A
authors.lastname: Cotten
authors.forename: Robin
authors.initials: R
authors.lastname: Azoulay
authors.forename: Catherine
authors.initials: C
authors.lastname: Adamsbaum
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D010019:Osteomyelitis / Q000473:pathology*; D012008:Recurrence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D051598:Whole Body Imaging / Q000379:methods*