Purpose or Case Report: This educational exhibit aims to :
1. Discuss the pathogenesis of Chronic Recurrent Multifocal Osteomyelitis (CRMO) with enumeration of Diagnostic Clinical Criteria
2. Describe pertinent findings on whole body Short tau Inversion Recovery (STIR) MR Imaging.
3. Illustrate evolution of MR findings on follow up imaging.
4. Identify common imaging differentials to be considered and pitfalls to be avoided
Methods & Materials: All patients with a diagnosis of CRMO presenting to pediatric radiology department at our institute who have undergone whole body STIR MRI are retrospectively evaluated for pertinent imaging findings. The information will be used to create an educational exhibit organized as under:
Etiopathogenesis (Derangement of Primitive Immune System)
Characterstic sites of Involvement (Mandible, medial clavicle, around knee, pelvis)
Pros and Cons of different imaging modalities used.
Role of follow up imaging to elucidate temporal course of disease.
Results: Chronic Recurrent Multifocal osteomyelitis(CRMO) is an important clinical-radiological entity characterized by multifocal inflammatory lesions involving skeleton in Pediatric/Adolescent age-group. Though increasingly recognized, this entity is usually a diagnosis of exclusion. However, characterstic sites of involvement on imaging and characteristic clinical course of waxing and waning multifocal lesions in temporal course of disease can help narrow the diagnosis.
Conclusions: 1.CRMO is an important clinicoradiological entity, given its characterstic clinical and excellent outcome with appropriate management.
2.Diagnosis of CRMO can be made by referring clinicians’ high index of clinical suspicion and radiologists’ thorough knowledge of findings of CRMO on imaging.
3.A knowledge of characterstic sites of involvement and waxing and vaning pattern of involvement seen on whole body STIR MRI can help pinpoint the diagnosis and guide management for CRMO