Retrospective Review of 80 Patients with Chronic Recurrent Multifocal Osteomyelitis Evaluated by Pediatric Orthopaedic Surgeons

Background: Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a rare aseptic autoinflammatory disease with wide and vague clinical presentation that often mimics infection, malignancy, or benign conditions, leading to delayed diagnosis. Methods: Children diagnosed CRMO at single tertiary pediatric hospital in the United States between 2012 2022 who were evaluated by orthopaedic surgeon retrospectively reviewed for data. The differential diagnoses from surgeons recorded their initial presentation. Jansson criteria Bristol Criteria applied evaluate patients could have been spared biopsy. Results: 80 children (65% female) identified. mean age diagnosis was 10.28 + 3.52, follow up of 37.13 27.67 months delay 6.21 9.75 months. Common presenting symptoms antalgic gait (45%), local inflammation (30%), fever/fatigue (26.25%). 58% presented clinically unifocal, but 81% had multifocal on imaging. Radiographs unremarkable 35%, periosteal reaction/sclerosis (23%), lytic lesion (22%). On MRI, 72% marrow edema, reaction and/or osteitis (19%). 69% received whole-body 78% bone femur, tibia, pelvis, spine involved >30%. most common given related infection (34%) neoplasm (21%). found be more sensitive than diagnosing (OR 3.94, P <0.001) identified 80% Conclusions: This cohort US displayed an ambiguous A combination prompt referral rheumatology, scoring tools, biopsy when necessary, should used appropriately suspicion CRMO.