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Case Reports in Radiology
Volume 2012, Article ID 515761, 5 pages
http://dx.doi.org/10.1155/2012/515761
Case Report

Case Study: Chronic Recurrent Multifocal Osteomyelitis in the Femoral Diaphysis of a Young Female

1Department of Medical Imaging, Ottawa Hospital, University of Ottawa, Civic Campus, Ottawa, ON, Canada K1N 6N5
2Division of Orthopedic Surgery, Department of Surgery, Royal University Hospital, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8
3Department of Medical Imaging, Royal University Hospital, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8

Received 12 October 2011; Accepted 20 November 2011

Academic Editors: B. J. Barron and A. Matsuno

Copyright © 2012 Jeffrey S. Quon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronic recurrent multifocal osteomyelitis (CRMO) is relatively uncommon. Even though the name suggests it is the result of infection, this is not likely the case. Instead it is more likely the result of genetic, autoimmune, or autoinflammatory causes. Although CRMO has a benign course and responds well to anti-inflammatory medications, it can have a very aggressive clinical and imaging presentation overlapping with infectious osteomyelitis and malignancy. Therefore, radiologists and clinicians need to be aware of its clinical and imaging presentation to avoid morbidity associated with more aggressive treatment. We present the case of a ten-year-old female with CRMO as a solitary expansile-mixed lytic and sclerotic lesion in the distal femoral diaphysis. The diaphyseal location and mixed lytic and sclerotic appearance are less common and have an aggressive imaging appearance. We also review the pathophysiology, imaging findings, and therapeutic approach to this uncommon but clinically important condition.