Succesful treatment of diffuse sclerosing osteomyelitis of the mandible/mandibular chronic non-bacterial osteitis with intravenous pamidronate: resolution of pain and radiographic bone inflammation with improved cosmetic appearance - a case study
نویسندگان
چکیده
Methods A 4-year old Caucasian female was diagnosed with DSMO and prospectively followed from 2007-2014. She presented with a 20-month history of facial asymmetry and painful bony expansion of the left hemimandible. CT-scan revealed bone expansion suggestive of fibrous dysplasia, but two consecutive bone biopsies revealed inflammatory cells only. Infectious osteomyeltis was also suspected, but cultures were negative and IV and oral antibiotics were of no benefit. Focal MRI revealed bone marrow and soft tissue edema with periosteal reaction, consistent with DSMO. Subsequent whole-body MRI revealed no other bony lesions. Naproxen was of no benefit and she was started on monthly 1-day IV-PAM infusions (1st dose 0.5mg/kg; each subsequent dose: 1mg/kg). The response to treatment was assessed according to visual analogue score for pain ( VAS, 0=no pain; 10=maximum pain), sequential MRIs and clinical photos.
منابع مشابه
Chronic mandibular osteomyelitis with suspected underlying synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome: a case report
Chronic mandibular osteomyelitis is an intractable disease. In recent years, some case reports have related this disease process to synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, which is chronic with frequent remissions and exacerbations. This report describes a case of chronic mandibular osteomyelitis suspected to be SAPHO syndrome. A 68-year-old woman presented wit...
متن کاملRemarkable response of juvenile diffuse sclerosing osteomyelitis of mandible to pamidronate.
We report a juvenile case of diffuse sclerosing osteomyelitis of the mandible that showed a favorable response to pamidronate, a bisphosphonate derivative. Although conventional treatments had been ineffective for 5 years, pamidronate administration brought about conspicuous improvement both clinically and radiographically. Severe adverse reaction was not found except for low-grade fever and la...
متن کاملBone scintigraphy in diagnosing chronic recurrent multifocal osteomyelitis
A 10-year-old boy was referred to us for evaluation of FUO accompanied with bone pain in both calves. Three hours after intravenous injection of 13 mCi of 99mTc-MDP, whole body scan in multiple spot views was performed. The scan showed symmetrical areas of diffusely increased tracer uptake in multiple long bones. Histopathologic evaluation confirmed osteosclrosis and fibrotic changes...
متن کاملTherapeutic possibilities of long-term roxithromycin treatment for chronic diffuse sclerosing osteomyelitis of the mandible.
The clinical efficacy of long-term roxithromycin treatment was examined objectively in nine patients with chronic diffuse sclerosing osteomyelitis of the mandible. Roxithromycin was administered orally at a dose of 300 mg/day for between 68 days and 66 months. In seven of the nine cases (77.8%), the symptoms disappeared 1-12 months after the start of therapy. Radiography showed that osteolytic ...
متن کاملCase Report: Osteochondroma of the mandible
Osteochondroma is an osseous protuberance with cartilaginous growth potential that usually forms at the ends of long bones such as knee, hip, shoulder and joints(1). Osteochondromas are one of the most common benign tumours of bone, approximately 35% to 50% of all benign tumors and 8% to 15% of all primary bone tumors (2). Only about 1% of these occur within the head and neck region (1). The mo...
متن کامل