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
    — Radiograph: variable morphologies / densities – bubbly lucent, aggressive lytic, sclerotic
  • Clinical: primarily in children / adolescents, most common disease to affect medial 1/3rd 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.