Difficulties in Recognizing, Diagnosing Chronic Recurrent Multifocal Osteomyelitis

Recognizing and diagnosing chronic recurrent multifocal osteomyelitis (CRMO) remains difficult, said Anne M. Stevens, MD, PhD, of the department of rheumatology at Seattle Children’s Hospital in a presentation at the 2020 Rheumatology Winter Clinical Symposium.

Focal bone or joint pain, which may be worse at night, is typically the first indication of CRMO. The area may also be swollen. Areas typically affect include the clavicle, mandible, lower extremities, and spine.

Although lab results may come back normal, extraosseous may be an indication of CRMO; a biopsy can be performed to make sure there is no malignancy. Dr Stevens explained the diagnosis of CRMO as one exclusion.

Dr Stevens suggested adapting the umbrella term chronic nonbacterial osteomyelitis (CNO) because the disease can happen on specific, multifocal, or symmetric sites and can be based on concurrent cutaneous disease.

Reference

Stevens A. CNO/CRMO/SAPHO: Autoinflammatory disease(s) of the Year? Presented at: 2020 Rheumatology Winter Clinical Symposium; Feb. 12-15, 2020; Maui, Hawaii.