Syed Intakhab AlamHamad General Hospital, Qatar
Title: Chronic recurrent multifocal osteomyelitis and its management
Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory disorder of bones first reported by Giedion et al. in 1972. It is a disease of childhood, comparable to SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) in adults. CRMO presents with pain and swelling overlying the involved bones. Inflammatory markers are usually raised and X-rays usually show sclerotic lesions. MRI demonstrates the extent of the lesions accurately and associated soft tissue changes. Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are the mainstays of the management. We report three patients who presented with bone pains. Extensive workup and radiological modalities along with clinical findings supported the diagnosis of CRMO. This article highlights important clinical presentations, radiological findings, and various management options. From our cases and review of the literature, we conclude that CRMO is a diagnosis of exclusion and biopsy should be performed to surely rule out the underlying malignant processes. Most patients respond well to NSAIDs and corticosteroids; however, interleukin 1 inhibitors and the role of DMARDs role have also been illustrated in the literature.
Syed Alam is an associate consultant in the department of clinical imaging at Hamad general hospital, Doha, Qatar. He is In-charge of the research committee in the department of clinical imaging and has been awarded the Best Teaching Faculty Award for the year 2014-2015. He was also the guest speaker in the Annual Scientific Meeting European Society of Musculoskeletal Radiology (ESSR) 2014, Riga, Latvia. He has been a speaker and tutor in the Qatar MSK Ultrasound Course every year from 2014-2021. He is a member of the European Society of Musculoskeletal Radiology and the Asian Musculoskeletal Radiology Society. He has published many articles in radiology journals and delivered many lectures in the Asian Musculoskeletal Society.