title: Unusual onset of a case of chronic recurrent multifocal osteomyelitis.
abstract: BACKGROUND
  Chronic recurrent multifocal osteomyelitis (CRMO) is a rare condition that commonly affects the clavicle and pelvis.
  
  
  METHODS
  We report here a case a 12 years old girl with CRMO arising with recurrent episodes of left supraorbital headache, followed by the appearance of a periorbital dyschromia. Magnetic resonance imaging (MRI) of the skull and orbits revealed an important subacute inflammatory process. Few months after, the child presented a painful swelling of the left clavicle; the histological examination of the related biopsy allowed to establish the diagnosis of CRMO.
  
  
  CONCLUSIONS
  CRMO presenting as acute headache involving neurocranium is rare; to our knowledge this is the first recognized case in the world literature. This pathological condition is frequently misdiagnosed as infection or neoplasm and needs a deep investigation for the differential diagnosis. The physical, laboratoristic and instrumental diagnostic investigations of the patient and the treatment employed are described in detail.
authors.affiliation: Department of Pediatrics, Immunology and Rheumatology Section, University of Pisa, Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Barrani
authors.affiliation: Department of Pediatrics, Immunology and Rheumatology Section, University of Pisa, Pisa, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Massei
authors.affiliation: Department of Orthopedics, University of Pisa, Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Scaglione
authors.affiliation: Department of Diagnostic Radiology, University of Pisa, Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Paolicchi
authors.affiliation: Department of Diagnostic Radiology, University of Pisa, Pisa, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Vitali
authors.affiliation: Department of Pathology, University of Pisa, Pisa, Italy.
authors.forename: E M
authors.initials: EM
authors.lastname: Ciancia
authors.affiliation: Department of Genetics, University of Trieste, Trieste, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Crovella
authors.affiliation: Department of Pediatrics, Immunology and Rheumatology Section, University of Pisa, Pisa, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Caparello
authors.affiliation: Department of Pediatrics, Immunology and Rheumatology Section, University of Pisa, Pisa, Italy. rita.consolini@med.unipi.it.
authors.forename: R
authors.initials: R
authors.lastname: Consolini
mesh_terms: D002648:Child; D002968:Clavicle / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009916:Orbital Diseases / Q000209:etiology; D010019:Osteomyelitis / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed