Skull involvement in a pediatric case of chronic recurrent multifocal osteomyelitis

• Published in: Nagoya journal of medical science Vol. 77; no. 3; pp. 493 - 500
• Main Authors: Watanabe, Toru, Ono, Hiroyuki, Morimoto, Yoshitaka, Otsuki, Yoshiro, Shirai, Masami, Endoh, Akira, Naito, Masaaki, Inoue, Yoshiya, Hongo, Teruaki
• Format: Journal Article
• Language: English
• Published: Japan Nagoya University 01.08.2015
• Subjects: Case Report; bone pain; chronic nonbacterial osteomyelitis; non-steroidal anti-inflammatory drugs; skull; auto inflammatory diseases
• ISSN: 0027-7622; 2186-3326

An 11-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis (CRMO) and presented with right sacro-femoral and occipital lesions. Initially, a tumor was suspected. However, the bone biopsy showed osteomyelitis with a negative bacterial culture. Bone scintigraphy revealed inflammatory changes on multiple bone lesions. The slight elevation in inflammatory markers such as C-reactive protein was of little clinical value. He was diagnosed with CRMO by sacral biopsy, and the clinical course progressed, with the presence of a new occipital lesion observed after the 1-year follow-up. The administration of non-steroidal anti-inflammatory drugs successfully improved his clinical symptoms. The presence of a skull lesion in the occipital bone of a pediatric patient with CRMO has not been previously reported.