Chronic Recurrent Multifocal Osteomyelitis - A Case Report

Introduction: Chronic recurrent multifocal osteomyelitis (CRMO) is a benign, noninfectious, self-limiting inflammatory bone disease that predominantly affects children and adolescents, characterized by multiple, recurrent osteolytic and sclerotic lesions typically involving the metaphysis of long tu...

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Main Authors: Cecil K Eldhose, Mohammed Tavfiq, J K Giriraj Harshavardhan, Sundar Suriyakumar, C Sitsabesan
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-08-01
Series:Journal of Orthopaedic Case Reports
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Online Access:https://jocr.co.in/wp/2025/08/01/chronic-recurrent-multifocal-osteomyelitis-a-case-report/
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author Cecil K Eldhose
Mohammed Tavfiq
J K Giriraj Harshavardhan
Sundar Suriyakumar
C Sitsabesan
author_facet Cecil K Eldhose
Mohammed Tavfiq
J K Giriraj Harshavardhan
Sundar Suriyakumar
C Sitsabesan
author_sort Cecil K Eldhose
collection DOAJ
description Introduction: Chronic recurrent multifocal osteomyelitis (CRMO) is a benign, noninfectious, self-limiting inflammatory bone disease that predominantly affects children and adolescents, characterized by multiple, recurrent osteolytic and sclerotic lesions typically involving the metaphysis of long tubular bones, clavicle, spine, and pelvic. The clavicle, particularly its medial end, is the most common and characteristic site affected. Case Report: A 13-year-old boy presented with a 5-month history of acute gradually progressive, dull aching pain over the bilateral hip radiating to the thigh, knee, and ankle. Myeloproliferative disorders were ruled out with a bone marrow biopsy. Magnetic resonance imaging pelvis with hip, thigh, and clavicle screening showed altered signal intensities involving the bilateral acetabulum, pubic bones, iliac bone, right femur, bilateral tibia, and clavicle, along with diffuse periosteal thickening involving the left iliac wing. After ruling out all possible differential diagnosis and discussion in a multidisciplinary team, a final diagnosis of CRMO was made. The patient was started on Inj. Pamidronate and responded well to treatment. Conclusion: CRMO is a rare benign bone lesion with diverse clinical presentation and lack of specific clinical, laboratory, or pathological features, which leads to misdiagnosis or delayed diagnosis. A high index of suspicion and characteristic radiological involvement of the clavicle may help to clinch the diagnosis. Familiarity with this condition greatly increases the likelihood of early diagnosis and appropriate management.
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spelling doaj-art-b6c67087e142451a80d6b89aa942b6d82025-08-20T03:36:58ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-08-01158414510.13107/jocr.2025.v15.i08.5876Chronic Recurrent Multifocal Osteomyelitis - A Case ReportCecil K EldhoseMohammed TavfiqJ K Giriraj HarshavardhanSundar SuriyakumarC SitsabesanIntroduction: Chronic recurrent multifocal osteomyelitis (CRMO) is a benign, noninfectious, self-limiting inflammatory bone disease that predominantly affects children and adolescents, characterized by multiple, recurrent osteolytic and sclerotic lesions typically involving the metaphysis of long tubular bones, clavicle, spine, and pelvic. The clavicle, particularly its medial end, is the most common and characteristic site affected. Case Report: A 13-year-old boy presented with a 5-month history of acute gradually progressive, dull aching pain over the bilateral hip radiating to the thigh, knee, and ankle. Myeloproliferative disorders were ruled out with a bone marrow biopsy. Magnetic resonance imaging pelvis with hip, thigh, and clavicle screening showed altered signal intensities involving the bilateral acetabulum, pubic bones, iliac bone, right femur, bilateral tibia, and clavicle, along with diffuse periosteal thickening involving the left iliac wing. After ruling out all possible differential diagnosis and discussion in a multidisciplinary team, a final diagnosis of CRMO was made. The patient was started on Inj. Pamidronate and responded well to treatment. Conclusion: CRMO is a rare benign bone lesion with diverse clinical presentation and lack of specific clinical, laboratory, or pathological features, which leads to misdiagnosis or delayed diagnosis. A high index of suspicion and characteristic radiological involvement of the clavicle may help to clinch the diagnosis. Familiarity with this condition greatly increases the likelihood of early diagnosis and appropriate management.https://jocr.co.in/wp/2025/08/01/chronic-recurrent-multifocal-osteomyelitis-a-case-report/chronic recurrent multifocal osteomyelitisclavicleinflammatory
spellingShingle Cecil K Eldhose
Mohammed Tavfiq
J K Giriraj Harshavardhan
Sundar Suriyakumar
C Sitsabesan
Chronic Recurrent Multifocal Osteomyelitis - A Case Report
Journal of Orthopaedic Case Reports
chronic recurrent multifocal osteomyelitis
clavicle
inflammatory
title Chronic Recurrent Multifocal Osteomyelitis - A Case Report
title_full Chronic Recurrent Multifocal Osteomyelitis - A Case Report
title_fullStr Chronic Recurrent Multifocal Osteomyelitis - A Case Report
title_full_unstemmed Chronic Recurrent Multifocal Osteomyelitis - A Case Report
title_short Chronic Recurrent Multifocal Osteomyelitis - A Case Report
title_sort chronic recurrent multifocal osteomyelitis a case report
topic chronic recurrent multifocal osteomyelitis
clavicle
inflammatory
url https://jocr.co.in/wp/2025/08/01/chronic-recurrent-multifocal-osteomyelitis-a-case-report/
work_keys_str_mv AT cecilkeldhose chronicrecurrentmultifocalosteomyelitisacasereport
AT mohammedtavfiq chronicrecurrentmultifocalosteomyelitisacasereport
AT jkgirirajharshavardhan chronicrecurrentmultifocalosteomyelitisacasereport
AT sundarsuriyakumar chronicrecurrentmultifocalosteomyelitisacasereport
AT csitsabesan chronicrecurrentmultifocalosteomyelitisacasereport