Bisphosphonate treatment in chronic recurrent multifocal osteomyelitis

J Pediatr. 2008 Apr;152(4):571-5. doi: 10.1016/j.jpeds.2007.08.047. Epub 2007 Nov 5.


Objective: To test the safety and efficacy of biphosphonates in chronic recurrent multifocal osteomyelitis (CRMO).

Study design: Five patients with CRMO, all of whom had ongoing pain and loss of function despite conventional treatment with non-steroidal anti-inflammatory agents, were treated with pamidronate (1 mg/kg/dose with a dosing frequency of 2 to 4 monthly for a total treatment duration of 12 to 42 months).

Results: Pain decreased after the first infusion for 4 of 5 patients, with symptomatic improvement maintained with time. Significant improvement was seen in radiological lesions for these 4 patients.

Conclusion: Bisphosphonates appear to be a useful and safe adjunctive treatment in CRMO when simple therapies such as anti-inflammatory agents fail to control symptoms or cases in which lesion expansion continues.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Child
  • Chronic Disease
  • Diphosphonates / therapeutic use*
  • Female
  • Humans
  • Male
  • Osteomyelitis / drug therapy*
  • Pamidronate
  • Recurrence


  • Diphosphonates
  • Pamidronate