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PO-0371 Clinical Features And Clinical Outcome In Children With Chronic Recurrent Multifocal Osteomyelitis: The Experience Of A Tertiary Paediatric Centre
  1. L Martins1,
  2. C Alves1,
  3. I Balacó1,
  4. P Estanqueiro2,
  5. MB Salgado2,
  6. G Matos1
  1. 1Department of Pediatric Orthopedics, Centro Hospitalar Universitário de Coimbra EPE-Hospital Pediátrico, Coimbra, Portugal
  2. 2Department of Pediatrics Pediatric Rheumatology Unit, Centro Hospitalar Universitário de Coimbra EPE- Hospital Pediátrico, Coimbra, Portugal

Abstract

Introduction Chronic recurrent multifocal osteomyelitis (CRMO) is a rare auto-inflamatory bone disease, primarily affecting children and adolescents.

Objective To determine the clinical features and functional outcomes of children with CRMO treated between 1995 and 2013 in a tertiary paediatric hospital.

Methods We retrospectively reviewed clinical features of children with CRMO. Outcomes were obtained through telephonic interview. The Health Assessment Questionnaire (HAQ) disability índex and the Quick Dash questionnaire were applied. Upper limb disability of patients with clavicular involvement was compared with a control group of children who had a previous forearm fracture.

Results Nine patients were assessed (6 males and 3 females). Mean age at onset was 8 years; mean age at diagnosis 10,3 years. Mean number of bony lesions were 3 at onset and 3,4 over the disease course. The more frequently affected site was clavicle (55,6%). Pain was the most frequent clinical sign of the disease (88,9%) associated with swelling (77,8%). Patients were treated with steroids (88,9%), methotrexate (44,4%), pamidronate (22,2%) and NSAID (100%). Five patients presented residual bone deformity (including two with inactive disease). All patients reported no physical disability as judged by the HAQ 0–1. However, patients with clavicular involvement (5) scored significantly worst on Quick Dash when compared to the control group (p = 0,015).

Conclusions Although the clinical outcome of children with CRMO is generally considered good, using an upper-extremity outcome measure (Quick DASH) allows us to understand that these patients experience upper limb difficulties in their daily lives.

Keywords
  • Chronic recurrent multifocal osteomyelitis
  • Health Assessment Questionnaire
  • Quick Dash

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