Pediatric Chronic Recurrent Multifocal Osteomyelitis

  • Etiology: Idiopathic episodic auto-inflammatory disorder with nonbacterial multifocal osteomyelitis
  • Imaging:
    — Usually asymmetric and metachronous, no significant fluid
    — Most common locations: Metaphyses of long bones, medial clavicles, vertebral bodies, mandible, pelvis, ribs
  • Imaging Radiograph: Variable morphologies or densities – bubbly lucent, aggressive lytic, sclerotic
  • Imaging MRI: Whole body STIR MRI used to monitor disease course
  • DDX:
  • Complications:
  • Treatment:
  • Clinical:
    — Primarily in children and adolescents
    — Most common disease to affect medial 1/3 of clavicle

Radiology Cases of Chronic Recurrent Multifocal Osteomyelitis

Radiograph and CT of chronic recurrent multifocal osteomyelitis (CRMO)
AP and lateral radiographs of the spine (2 left-most images) show hyperostosis of the medial aspect of the bilateral clavicles and flattening (vertebra plana) of the T4, T7 and T8 vertebral bodies. Coronal and sagittal 2D reconstructions from a CT without contrast of the spine (2 right-most images) show in more detail the vertebra plana of the T4, T7 and T8 vertebral bodies.