[Chronic recurrent multifocal osteomyelitis-- I. Review]

Klin Padiatr. Sep-Oct 2001;213(5):271-6. doi: 10.1055/s-2001-17218.
[Article in German]


Juvenile and adolescent "Chronic Recurrent Multifocal Osteomyelitis" (CRMO) is described on the basis of literature and analysis of 43 own cases (23 cases in children or adolescents). This systemic, non-purulent inflammatory disease occurs mainly metaphyseal in long bones, in pelvic bones or as spondylitis and is not as rare as it seemed. Basis of the disease is a primarily chronic, sterile, in phase of onset often monotopic (e.g. clavicle) and later frequently polytopic osteomyelitis, possibly triggered by an immuno-pathological process (e.g. Proprionibacterium acnes), and showing histologically plasmacellular invasion and a sclerosing process in different stages. Association with pustulous dermatosis (psoriasis, acne, palmo-plantar pustulosis) is found in about 25 % of children and adolescents and in more than 50 % of the adult patients. 5 differents types of distribution of osteomyelitic lesions can be found by using Te99m-bone scan primarily, of which the "pelvic type" is the most common. Because of the close neighbourhood of meta-/epiphyseal osteomyelitic focuses, "sympathetic arthritis" with synovitis is seen frequently. A therapeutic approach with azithromycine and calcitonine is presented.

Publication types

  • Comparative Study
  • English Abstract
  • Review

MeSH terms

  • Acquired Hyperostosis Syndrome / diagnosis
  • Adolescent
  • Adult
  • Age Factors
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / administration & dosage
  • Azithromycin / therapeutic use
  • Child
  • Child, Preschool
  • Chronic Disease
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Osteomyelitis* / diagnosis
  • Osteomyelitis* / drug therapy
  • Osteomyelitis* / etiology
  • Recurrence
  • Time Factors


  • Anti-Bacterial Agents
  • Azithromycin