Polly J. Ferguson, MD

ABSTRACT: Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disease that occurs primarily in childhood. The clinical picture often is confused with bacterial osteomyelitis. Awareness of CRMO as a clinical entity helps avoid diagnosis and treatment delays. Our patient, an 8-year-old girl, presented with acute left hip pain. One month after presentation, a lytic lesion was seen on plain radiographs; biopsy revealed nonspecific inflammation. It was not until more than 2 years later, when multifocal bone lesions and psoriasis developed, that the diagnosis became clear. Our patient's case demonstrates several key points: not all children with CRMO present with multifocal disease, patients frequently have comorbid inflammatory conditions, and there are no diagnostic laboratory studies. The optimal treatments remain unknown.