Definition

What is Chronic recurrent multifocal osteomyelitis (CRMO)?

Chronic recurrent multifocal osteomyelitis (CRMO) involves inflammation of the bone.

Usually, inflammation is a normal process. It causes pain, redness, and swelling. It is the way our immune system protects itself from infection and germs. In CRMO, however, there is no infection. Instead, the immune system wrongly attacks normal bone (auto-inflammatory disorder), causing inflammation and prolonged and fluctuating course with recurrent episodes of pain occurring over several years.

CRMO is most often seen in the clavicle and tubular bones, and less frequently pelvic bones and the spine.

How common is Chronic recurrent multifocal osteomyelitis (CRMO)?

This is a very rare disease and generally is found in children, generally girls. It may also affect adults. CRMO may develop in children ages between 4 and 14. The most common starting point for the development of this condition is age of 10. There have been no epidemiological data on incidence so far. However, the incidence of Chronic Recurrent Multifocal Osteomyelitis (CRMO) might be estimated at 1:1,000,000. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Chronic recurrent multifocal osteomyelitis (CRMO)?

CRMO damages create characteristic formations known as bone lesions in the affected area of bone. When these lesions flare-up, they cause problems to include aching pain, a pronounced limp, possible constitutional upset, fever, and swelling skin redness.

The pain may limit the child’s activities and it can be quite severe. Sometimes the child may even require hospitalization. CRMO mainly affects long bone metaphyses and also shoulder girdle and pelvis. The bones that this disease affects more include thighbone, clavicle and shinbone. There are many young people with CRMO who have more than one area of bone pain.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you or your loved one has any signs or symptoms listed above or you have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Chronic recurrent multifocal osteomyelitis (CRMO)?

The cause of CMRO is unknown. The possible causes of CMRO include autoimmune reaction (where white blood cells instead of seeking out and destroying foreign invaders turn on the body and attack normal cells instead), infectious disease, and a defect in immune system.

Risk factors

What increases my risk for Chronic recurrent multifocal osteomyelitis (CRMO)?

Sometimes children with other diseases such as bowel inflammation (colitis) or psoriasis (a skin condition) also develop CRMO. Since the other diseases seem to run in families, CRMO may also be genetic. Researchers are looking into this.

Please consult with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Chronic recurrent multifocal osteomyelitis (CRMO) diagnosed?

CRMO is a “diagnosis of exclusion.” This means that other diseases must be excluded before the diagnosis can be made. Many tests are often required. These include blood tests, X-rays, bone scans, MRI, and often a bone biopsy.

How is Chronic recurrent multifocal osteomyelitis (CRMO) treated?

Still, it is impossible to give effective and definite treatment for CRMO. Treatment aim is to try to treat them if they occur and prevent flareups. To monitor any growth disturbances in the affected bones, it usually requires long term treatment.

Most attacks of CRMO can be managed with nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines are taken by mouth. They are called the first line of treatment. The two most common NSAIDs are naproxen and indomethacin.

If NSAIDs are not effective, there are other drugs called second line treatments. These include:

  • Corticosteroids (prednisone)
  • Bisphosphonates (pamidronate)
  • Biologics (etanercept, infliximab, adalimumab, anakinra)

Studies are being done to determine the best second line treatment.

Other treatments include:

Physical Therapy: Physical therapy is advised following complete recovery from inflammatory bone condition to improve muscle function and joint mobility. Physical therapist is avoided during symptoms caused by active inflammatory condition.

Steroids: Regular doses of steroids are used in severe case of CRMO. It slows down the inflammation and allows the bone to heal. In some specific cases, bisphosphonates, sulfasalazine and oral steroids have also been used.

Surgical Operations: There are few case reports suggests surgical treatment has helped to improve healing and accomplished rapid anti inflammatory therapy. Surgical treatment is controversial and most specialist advised to avoid surgery.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Chronic recurrent multifocal osteomyelitis (CRMO)?

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 8, 2018 | Last Modified: March 8, 2018

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.