Chronic recurrent multifocal osteomyelitis.

The aim of this paper is to give a detailed description of the so-called "c hronic recurrent multifocal osteomyelitis" (CRMO). The clinical, radiologic al and histopathological results of an analysis of 29 cases (15 children/ad olescents and 14 adults) are presented and correlated to current data from the literature. We could delinate the following points: 1. CRMO is a system ic aseptic inflammation of the bone marrow (Osteitis), it can occur polytop ically and association with pustulous dermatologic symptoms is possible. 2. It is not a rare disease! 3. Osteomyelitis is probably "reactive" and a pl asma-cell sclerotic process with ist own characteristic histologic three-ph ase course. 4. We could observe 5 specific types of localization which can be documented by X-ray or bone scan. 5. Accompanying arthritis os often pre sent, especially "sympathetic coxitis". 6. The use of drugs in treatment of CRMO (i.e. azithromycin, calcitonin, and bisphosphonates) is discussed. In conclusion we want to point out, that 1. (TC)-T-99m bone scan should alway s be performed when there is suspicion for CRMO to reveal the pattern of af fection, 2. the rheumatologist and dermatologist should be contacted, 3. op eration is normally not necessary for treatment of the mostly self-limitin disease, and 4. the term "SAPHO syndrome" should be avoided, further differ entiation of the diagnosis is necessary.