Crohn's-associated chronic recurrent multifocal osteomyelitis responsive to infliximab
Section snippets
Case report
The patient initially presented in January of 1999 at the age of 9 years, with a 5-month history of right arm pain, and was eventually found to have a mass over the right clavicle. Radiographs of the mass suggested infection, and, on biopsy, acute and chronic inflammation were noted, though cultures were negative for bacteria, fungi, and mycobacteria. At initial presentation, a fracture was seen through the lesion that had occurred after a fall. A normal complete blood count, a C-reactive
Discussion
CRMO is believed to be an autoimmune process that has been associated with a variety of other entities, including psoriasis, palmoplantar pustulosis, and SAPHO syndrome, which is characterized by synovitis, acne, pustulosis, hyperostosis, and osteitis.5 Our patient had sternoclavicular hyperostosis, a distinct entity in which clinical examination, imaging features, biopsy, and histopathologic findings are consistent with CRMO, though localization of the inflammatory lesion is isolated to the
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Chronic nonbacterial osteomyelitis (CNO) and chronic recurrent multifocal osteomyelitis (CRMO)
2021, Journal of Translational AutoimmunityCitation Excerpt :Thus, TNF inhibitors have been used in the treatment of CNO/CRMO and induce clinical and radiological remission in a large proportion of patients. However, due to the off-label character and relatively high associated costs, cytokine blocking strategies should only be considered for cases refractory to other treatments [18,55,68,112,119,120]. Additional preliminary evidence for the efficacy of biological DMARDs in SAPHO exists and promises potential also for the use in “classical” CNO [45,121].
Effects of Digestive Diseases on Bone Metabolism
2020, Pediatric Gastrointestinal and Liver Disease, Sixth EditionAutoinflammatory diseases affecting bone and joints, and autoinflammatory interferonopathies
2020, Stiehm's Immune Deficiencies: Inborn Errors of ImmunityClinical characteristics and treatment of clavicular osteomyelitis: a systematic review with pooled analysis of 294 reported cases
2019, Journal of Shoulder and Elbow SurgeryCitation Excerpt :A total of 191 potentially relevant English reports were identified initially. After referencing the titles, abstracts, and full texts, 111 studies1-15,17-22,24-40,42-45,47-49,51-54,56,59-73,75,76,79-88,90-95,97-107,110-118,120-124,126-128 with 294 cases were included in the final analysis. The eligibility selection process is shown in Figure 1.
Non-bacterial chronic osteomyelitis: Experience in a tertiary hospital
2016, Anales de PediatriaChronic Recurrent Multifocal Osteomyelitis and Related Disorders
2016, Handbook of Systemic Autoimmune DiseasesCitation Excerpt :The strongest association is between CRMO and inflammatory skin conditions including palmoplantar pustulosis [49,91,94–98], psoriasis vulgaris [49,91,98,99], severe acne [49,91,100,101], generalized pustulosis [71], pyoderma gangrenosum [22,102,103], Sweet syndrome [57,61,104,105], and panniculitis [91]. Inflammatory bowel disease occurs in approximately 10% of individuals with CRMO, most often Crohn's disease, but ulcerative colitis and celiac disease also occur [5,22,26,49,106–115]. Inflammatory arthritis occurs in up to 80% of individuals with CRMO, most often with inflammation in the joint adjacent to a bone lesion but synovitis distant from sites of osteitis can also occur [2,4,5,22,49,91].