Aim To assess the role of whole-body MRI (WB MRI) in the diagnosis and management of patients with Chronic Recurrent Multifocal Osteomyelitis (CRMO). CRMO is a benign and non-infective autoinflammatory bone disorder characterised by multiple and recurrent inflammatory bone lesions. No universal diagnostic criteria exist.
Methods Retrospective review of CRMO cases diagnosed at this hospital between 2008 to 2014. Cases were identified from patient records, and clinical information was collated from radiology and histopathology records and individual case notes.
Results Forty seven CRMO patients were identified who had had WB MRI, of these 34 were paediatric patients up to the age of 18 years. The number of WB MRI scans per case ranged from 1 to 5 [mean 1.5]. WB MRI identified multifocal lesions in 30 patients. The clavicle, tibia and femur were most frequently involved. All cases were managed with non-steroidal anti-inflammatory medication or bisphosphonates. No children required steroid or anti-TNF treatment or surgical resection.
Conclusions In the absence of specific diagnostic criteria, WB MRI in combination with clinical assessment can aid in the diagnosis of CRMO. WB MRI has almost entirely replaced bone biopsy in the diagnosis of CRMO at our institution.
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