Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis

We report a case of a 13-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) who developed severe arthritis in four different joints within the first year from the onset of the disease. Her multiple vertebrae lesions showed significant amelioration after a 2-month treatment with pre...

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Main Authors: Elena Tsitsami, Vasiliki Dermentzoglou, Mary Moschovi, George P. Chrousos
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Rheumatology
Online Access:http://dx.doi.org/10.1155/2011/210795
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author Elena Tsitsami
Vasiliki Dermentzoglou
Mary Moschovi
George P. Chrousos
author_facet Elena Tsitsami
Vasiliki Dermentzoglou
Mary Moschovi
George P. Chrousos
author_sort Elena Tsitsami
collection DOAJ
description We report a case of a 13-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) who developed severe arthritis in four different joints within the first year from the onset of the disease. Her multiple vertebrae lesions showed significant amelioration after a 2-month treatment with prednisolone. In parallel, the initial severe symmetrical arthritis of both knees showing overt synovitis and joint effusion, in the absence of lesions in the metaphyses of the femur or the tibia, responded remarkably well in intra-articular triamcinolone hexacetonide injections. However, upon discontinuation of prednisolone, the patient developed severe arthritis of her right ankle and the proximal interphalangeal joint of her right middle finger. Thus, prednisolone was reinitiated combined with methotrexate, and the patient went into remission, which persists one year after prednisolone tapering. The appearance of arthritis in both knees in the absence of bone lesions and the emergence of severe arthritis of the ankle after remission of spinal bone lesions suggest that CRMO and juvenile idiopathic arthritis may coexist and be causally related.
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spelling doaj-art-70ec03a5b28f4a708ac491f6737372e62025-08-20T03:33:57ZengWileyCase Reports in Rheumatology2090-68892090-68972011-01-01201110.1155/2011/210795210795Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic ArthritisElena Tsitsami0Vasiliki Dermentzoglou1Mary Moschovi2George P. Chrousos3Pediatric Rheumatology Unit, 1st Department of Pediatrics, Children's Hospital Aghia Sophia, University of Athens, 115 27 Athens, GreeceDepartment of Radiology, Children's Hospital Aghia Sophia, 115 27 Athens, GreeceHematology Oncology Unit, 1st Department of Pediatrics, Children's Hospital Aghia Sophia, University of Athens, 115 27 Athens, Greece1st Department of Pediatrics, Children's Hospital Aghia Sophia, University of Athens, 115 27 Athens, GreeceWe report a case of a 13-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) who developed severe arthritis in four different joints within the first year from the onset of the disease. Her multiple vertebrae lesions showed significant amelioration after a 2-month treatment with prednisolone. In parallel, the initial severe symmetrical arthritis of both knees showing overt synovitis and joint effusion, in the absence of lesions in the metaphyses of the femur or the tibia, responded remarkably well in intra-articular triamcinolone hexacetonide injections. However, upon discontinuation of prednisolone, the patient developed severe arthritis of her right ankle and the proximal interphalangeal joint of her right middle finger. Thus, prednisolone was reinitiated combined with methotrexate, and the patient went into remission, which persists one year after prednisolone tapering. The appearance of arthritis in both knees in the absence of bone lesions and the emergence of severe arthritis of the ankle after remission of spinal bone lesions suggest that CRMO and juvenile idiopathic arthritis may coexist and be causally related.http://dx.doi.org/10.1155/2011/210795
spellingShingle Elena Tsitsami
Vasiliki Dermentzoglou
Mary Moschovi
George P. Chrousos
Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis
Case Reports in Rheumatology
title Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis
title_full Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis
title_fullStr Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis
title_full_unstemmed Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis
title_short Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis
title_sort chronic recurrent multifocal osteomyelitis with concomitant features of juvenile idiopathic arthritis
url http://dx.doi.org/10.1155/2011/210795
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AT vasilikidermentzoglou chronicrecurrentmultifocalosteomyelitiswithconcomitantfeaturesofjuvenileidiopathicarthritis
AT marymoschovi chronicrecurrentmultifocalosteomyelitiswithconcomitantfeaturesofjuvenileidiopathicarthritis
AT georgepchrousos chronicrecurrentmultifocalosteomyelitiswithconcomitantfeaturesofjuvenileidiopathicarthritis