Chronic recurrent multifocal osteomyelitis manifested as painful clavicular swelling: a case report.
BACKGROUND
Chronic recurrent multifocal osteomyelitis is a form of non-bacterial osteomyelitis which occurs primarily in childhood. In some cases painful bone swelling occurs. After a malignancy has been ruled out, antibiotic therapy is often started to treat the osteomyelitis. The course of this benign disease is self-limiting and is not positively affected by the antibiotic therapy.


METHODS
A 14-year-old German girl from South Africa came to the surgery with painful swelling in the right clavicle. The condition had first appeared two months earlier. The patient was unable to identify a trigger. In addition, the patient exhibited painless swelling in the area of the 5th metatarsal of the left foot. Chronic recurrent multifocal osteomyelitis was diagnosed based on characteristic clinical symptoms and imaging. Treatment with ibuprofen had caused the symptoms to regress rapidly.


CONCLUSIONS
The case demonstrates to general practitioners and other clinicians that a prolonged administration of antibiotics can be prevented by means of a comprehensive diagnostic procedure for possible bacterial osteomyelitis.
Department of General Practice and Family Medicine, University Medical Center Friedrich-Wilhelm University Bonn, Sigmund-Freud-Str, 25, 53127 Bonn, Germany. markus.bleckwenn@ukb.uni-bonn.de.
Markus
M
Bleckwenn
Bernd
B
Sommer
Klaus
K
Weckbecker
D002648:Child; D002968:Clavicle / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010019:Osteomyelitis / Q000150:complications* / Q000000981:diagnostic imaging; D020069:Shoulder Pain / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed