Correspondence
Chronic Recurrent Multifocal Osteomyelitis
Dtsch Arztebl Int 2010; 107(9): 148. DOI: 10.3238/arztebl.2010.0148a


CRMO does not manifest in sterile abscesses—which by definition do not actually exist—but in larger areas of sometimes “migrating” sterile inflammation of the bone, the localization being age dependent. These inflammations develop in three stages are and primarily lymphoplasmacellular, not “purulent”—that is, never granular leukocyte related. Magnetic resonance tomography and biopsy specimens usually provide unequivocal findings that morphologically depend on which stage of development the pathological process has reached. Further, the localization of the focus does not correspond to any of the 6 CRMO types, where none of the foci reside in the skullcap of CRMO patients. Corticosteroids are not indicated therapeutically.
A recently discovered common radiological feature may, however, erroneously link TB and CRMO in terms of the differential diagnosis: a potential paraosseous, especially paravertebral, inflammation of the soft tissues with a tendency to ossification, which may result in vertebral CRMO being mistaken for TB.
However, this specific differential diagnosis is not likely to be common. In our SAPHO/CRMO project in Mainz, there was only one case among 183 patients.
DOI: 10.3238/arztebl.2010.0148a
Prof. Dr. med. Fritz Schilling
Hebbelstr. 20
55127 Mainz, Germany
1.
Herzog A: Case report: dangerous errors in the diagnosis and treatment of bony tuberculosis [Gefährliche Fehler in Diagnostik und Therapie einer Knochentuberkulose]. Dtsch Arztebl Int 2009; 106(36): 573–7. VOLLTEXT
2.
Schilling F: Abschiedsvorlesung „CRMO“, Univ.-Klinik Mainz 2003.
1. | Herzog A: Case report: dangerous errors in the diagnosis and treatment of bony tuberculosis [Gefährliche Fehler in Diagnostik und Therapie einer Knochentuberkulose]. Dtsch Arztebl Int 2009; 106(36): 573–7. VOLLTEXT |
2. | Schilling F: Abschiedsvorlesung „CRMO“, Univ.-Klinik Mainz 2003. |