title: Skull involvement in a pediatric case of chronic recurrent multifocal osteomyelitis.
abstract: An 11-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis (CRMO) and presented with right sacro-femoral and occipital lesions. Initially, a tumor was suspected. However, the bone biopsy showed osteomyelitis with a negative bacterial culture. Bone scintigraphy revealed inflammatory changes on multiple bone lesions. The slight elevation in inflammatory markers such as C-reactive protein was of little clinical value. He was diagnosed with CRMO by sacral biopsy, and the clinical course progressed, with the presence of a new occipital lesion observed after the 1-year follow-up. The administration of non-steroidal anti-inflammatory drugs successfully improved his clinical symptoms. The presence of a skull lesion in the occipital bone of a pediatric patient with CRMO has not been previously reported.
authors.affiliation: Department of Pediatrics, Iwata City Hospital, Iwata, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Pediatrics, Iwata City Hospital, Iwata, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ono
authors.affiliation: Department of Orthopedics, Iwata City Hospital, Iwata, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Morimoto
authors.affiliation: Department of Diagnostic Pathology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Otsuki
authors.affiliation: Department of Pediatrics, Iwata City Hospital, Iwata, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Shirai
authors.affiliation: Department of Pediatrics, Iwata City Hospital, Iwata, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Endoh
authors.affiliation: Department of Diagnostic Radiology, Iwata City Hospital, Iwata, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Naito
authors.affiliation: Department of Surgery of Bone and Soft tissue tumor, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Inoue
authors.affiliation: Department of Pediatrics, Iwata City Hospital, Iwata, Japan.
authors.forename: Teruaki
authors.initials: T
authors.lastname: Hongo
keywords: auto inflammatory diseases; bone pain; chronic nonbacterial osteomyelitis; non-steroidal anti-inflammatory drugs; skull