title: Chronic recurrent multifocal osteomyelitis: a first report from Saudi Arabia.
abstract: OBJECTIVE
  Chronic recurrent multifocal osteomyelitis (CRMO) is a rare, systemic, aseptic, inflammatory disorder that involves different sites. Pathogenesis of chronic recurrent multifocal osteomyelitis is currently unknown. To our knowledge, there are no reports of CRMO from Saudi Arabia. We describe the clinical and laboratory features and treatment of a cohort of children with CRMO.
  
  
  METHODS
  Retrospective, patients referred to pediatric rheumatology clinic at a tertiary care center in Riyadh, Saudi Arabia.
  
  
  METHODS
  The diagnosis of CRMO was based on evidence of recurrent osteomyelitis with radiographic evidence of chronic osteomyelitis involving at least two sites in the absence of infectious cause in a child less than 14 years old.
  
  
  RESULTS
  Ten patients (9 female, 1 male) with CRMO; 2 patients presented in infancy. The referral diagnosis was inaccurate in all patients. All of them presented with pain and 8 of them had associated swelling and were found to have multifocal lesions. Imaging studies showed findings consistent with chronic osteomyelitis. Histopathological and microbiological examination confirmed the diagnosis in 9 patients. Cyclic pamidronate infusions induced good improvement in 6 patients.
  
  
  CONCLUSIONS
  This report indicates that CRMO may be overlooked in our community. Early diagnosis and treatment are required to avoid potential complications.
authors: Department of Pediatrics Rheumatology, King Faisal Specialist Hospital and Research Center, PO Box 3354 Riyadh 11211, Saudi Arabia. mayouf@kfshrc.edu.sa
authors: Maryam
authors: M
authors: Al Hajry
authors: Suliman
authors: S
authors: Al Jumaah
authors: Sulaiman M
authors: SM
authors: Almayouf
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis* / Q000453:epidemiology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology
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