Chronic recurrent multifocal osteomyelitis in a young female Sierra Leonean: A case report and review of literature

Abstract

Introduction: Chronic Recurrent Multifocal Osteomyelitis (CRMO) is an uncommon migratory skeletal disease with a non-infectious inflammatory cause. It is multifocal and affects the metaphyseal region of tubular bones. The prevalence is less than 1/1,000,000 and the onset is normally around 10 years and the female: male ratio is 4:1. It normally causes bone pain in children and adolescents. During the course of the disease, there are intermittent periods of exacerbation and remission. There are no specific clinical findings, and the diagnosis is by exclusion.

Case presentation: We present a 10-year-old female Sierra Leonean who was seen in our facility with a complaint of left shoulder pain and swelling and also left hip pain which started at the age of four years. However, it became more severe in the last three months prior to presentation after a fall from a standing position. There was no history of fever, cough or weight loss. A clinical examination, radiographs and blood investigations were done. She was then treated with Nonsteroidal anti-inflammatory drugs

(NSAIDS) and her condition improved remarkably after six months.

Conclusion: CRMO can be diagnosed based on diverse clinical features. It should be suspected in children who are having recurrent bone pain, mild increase in markers of inflammation with sclerotic or lytic lesions on radiographs. Therefore, accurate diagnosis and optimal treatment will avert complications such as bone damage.