Chronic recurrent multifocal osteomyelitis of clavicle: a rare isolated location: a case report

Khaled Kamoun, Wajdi Arfa, Malek Ben Chaalia, Wajih Oueslati, Leila Abid, Mourad Jenzri
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Abstract

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare disease. It is a non-microbial inflammatory bone affection that occurs more often in children with insidious onset and non specific presentation making diagnosis challenging. The aim of this study was to report a case of CRMO with unusual location. A 9-year-old child had a painful swelling over the medial side of clavicle with fixed mass. Radiographs showed osteolytic lesion on the medial part of clavicle extending to the acromioclavicular joint with soft tissue edema in magnetic resonance imaging (MRI). No inflammatory markers in biological exam. Needle biopsy, initially performed, suspected bone infection but children didn´t recover after 2 weeks of antibiotics. Surgical biopsy, histology sections was compatible with CRMO diagnosis. Children received a non steroid inflammatory drug with positive response, pain relief and decreasing of the clavicle swelling. CRMO should be suspected and biopsy is some time helpful in such unusual location.
锁骨慢性复发性多灶性骨髓炎:罕见的孤立部位:1例报告
慢性复发性多灶性骨髓炎(CRMO)是一种罕见的疾病。这是一种非微生物性炎症性骨病变,多发生在发病隐匿且无特异性表现的儿童中,使诊断具有挑战性。本研究的目的是报告一例异常位置的CRMO。一个9岁的孩子在锁骨内侧有一个疼痛的肿胀和固定肿块。x线片示锁骨内侧溶骨性病变延伸至肩锁关节,MRI显示软组织水肿。生物学检查未见炎症标志物。最初进行针活检,怀疑骨感染,但儿童在使用抗生素2周后未恢复。手术活检、组织学切片与CRMO诊断相符。儿童接受非类固醇消炎药治疗,反应积极,疼痛缓解,锁骨肿胀减轻。在这种不寻常的位置,应怀疑CRMO,活检有时是有帮助的。
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