CHRONIC RECURRING MULTIFOCAL OSTEOMYELITI S (CRMO) - A BRIEF SURVEY OF LITERATURE, NOSOLOGY, DIAGNOSTIC-CRITERIA AND RHEUMATOLOGIC DIFFERENTIAL-DIAGNOSIS

The rare disease of ''chronic recurrent multifocal osteomyelitis'' (CR MO) is reviewed from the world literature. CRMO is an acquired, asepti c skeletal disease mostly affecting children and young adolescents. Th e adult manifestation of CMRO often becomes a rheumatological problem of differential diagnosis: ''Adult CRMO''. This disease is based on a smoldering lymphoplasmacellular and chronic osteomyelitis which is mos t likely associated with immunopathogenetic mechanisms and consecutive ly self limiting sclerosis. This immunopathogenetic process may be tri ggered by infections. In 25% of the cases an association with the bone and cutaneous manifestations of pustulosis palmo-plantaris has been r eported which has been suggested to be of psoriatic origin. Clinical, radiographic and histopathological data are referred from the literatu re. We suggest diagnostic criteria and discuss the broad differential diagnosis of this disease entity within the hyperostotic spondarthriti des. The difficulties in attempts to classify CRMO as SAPHO syndrome a re emphasized. The hypothesis of the immunopathogenesis of ''chronic p oly-osteomyelitis'' is outlined and aims of further investigations on CRMO are defined.