Chronic recurrent multifocal osteomyelitis in pediatrics: A diagnostic challenge
| Autor: | M. Méndez-Hernández, M. Martínez-Morillo, N. Roig-Abraham |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
030203 arthritis & rheumatology
medicine.medical_specialty medicine.diagnostic_test business.industry Osteomyelitis Chronic recurrent multifocal osteomyelitis medicine.disease_cause medicine.disease Malignancy law.invention Lesion Intramedullary rod 03 medical and health sciences 0302 clinical medicine law Superinfection Biopsy medicine Orthopedics and Sports Medicine Surgery 030212 general & internal medicine Radiology medicine.symptom Differential diagnosis business |
| Zdroj: | Revista Española de Cirugía Ortopédica y Traumatología (English Edition). 63:447-450 |
| ISSN: | 1988-8856 |
| DOI: | 10.1016/j.recote.2019.09.001 |
| Popis: | Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disease that presents with aseptic bone inflammation and can be accompanied by multisystemic symptoms. We present the case of a 14-year-old male with a 2-week history of pain located at the tibial metaphysis and fever. X-ray revealed a lytic lesion in the tibial metaphysis. MRI revealed an intramedullary bone lesion with perilesional bone oedema. CT-guided biopsy discounted malignancy and microbiological cultures were negative. The patient's symptoms and fever worsened after the biopsy; therefore antibiotherapy was commenced for a suspected superinfection. A body MRI was performed given the persistence of the fever, which found a second active lesion in the spine that was diagnosed as CRMO and progressed well with anti-inflammatories. CRMO is an entity that is difficult to diagnose. Differential diagnosis is extensive with infectious diseases, tumours and other autoinflammatory diseases. Prompt diagnosis and appropriate treatment are crucial to prevent sequelae. |
| Databáze: | OpenAIRE |
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