What is the definition of Chronic Recurrent Multifocal Osteomyelitis?

Chronic recurrent multifocal osteomyelitis (CRMO) causes abnormal inflammation to occur in and around the bones. Symptoms usually begin in childhood but can occur at any age. Symptoms may include episodes of pain and joint swelling, skin redness, and sometimes a fever. In some cases, CRMO leads to abnormal bone growth, bone deformity, and fractures. Symptoms can last for years, and may go away on their own. CRMO may occur alone or with other skin or bowel inflammation conditions. In rare cases, CRMO occurs as part of one of these genetic syndromes: Majeed syndrome, DIRA or PAPA syndrome. The cause of CRMO is unknown, but a genetic influence is thought to be involved. Diagnosis of CRMO is based on the symptoms, clinical exam, and imaging studies. Other more common conditions may need to be excluded before a diagnosis of CRMO can be made. Treatment is focused on managing the symptoms and include medications such as non-steroidal anti-inflammatories, corticosteroids, and other drugs that reduce inflammation.

What are the alternative names for Chronic Recurrent Multifocal Osteomyelitis?

  • CRMO
  • Multifocal osteomyelitis, chronic
  • Chronic multifocal osteomyelitis
  • CMO
  • Chronic nonbacterial osteomyelitis/Chronic recurrent multifocal osteomyelitis
  • CNO/CRMO

What are the causes for Chronic Recurrent Multifocal Osteomyelitis?

The exact cause of chronic recurrent multifocal osteomyelitis (CRMO) is unknown. It is thought that genetics may play a role. In rare cases, CRMO can occur as part of Majeed syndrome, DIRA, or PAPA syndrome. All of these conditions occur due to a genetic variant in a single gene. 

What are the symptoms for Chronic Recurrent Multifocal Osteomyelitis?

The following list includes the most common signs and symptoms in people with chronic recurrent multifocal osteomyelitis (CRMO). These features may be different from person to person. Some people may have more symptoms than others, and they can range from mild to severe. This list does not include every symptom that has been described in the condition.

Symptoms may include:
  • Bone and joint pain
  • Skin redness and/or swelling
  • Inflammatory bowel disease
  • Psoriasis
  • Blister-like lesions on the palms and/or soles of the feet (palmoplantar pustulosis)
Symptoms typically start in childhood but can occur in any age. Symptoms range in severity from mild to severe. The bones most affected are the long bones, pelvis, shoulder girdle, and spine. CRMO can last from one to twenty years. In severe cases, bone deformities and fractures may occur.

What are the current treatments for Chronic Recurrent Multifocal Osteomyelitis?

Treatment for chronic recurrent multifocal osteomyelitis (CRMO) is focused on managing the symptoms. Treatment may include non-steroidal anti-inflammatory drugs, corticosteroids, and other drugs designed to control inflammation and prevent bone loss.

How is Chronic Recurrent Multifocal Osteomyelitis diagnosed?

Diagnosis of chronic recurrent multifocal osteomyelitis (CRMO) is based on the symptoms, clinical exam, and imaging studies. Other more common conditions may need to be excluded before CRMO can be diagnosed. Sometimes a bone biopsy is necessary to remove a small piece of bone for examination under the microscope.
  • Condition: Chronic Recurrent Multifocal Osteomyelitis (CRMO) Persisting into Adulthood
  • Journal: BMJ case reports
  • Treatment Used: Antibiotics
  • Number of Patients: 1
  • Published —
This case report describes a young man diagnosed with chronic recurrent multifocal osteomyelitis (CRMO) treated with antibiotics.
  • Condition: Spinal Chronic Non-Bacterial Osteomyelitis (CNO) in Children
  • Journal: Rheumatology international
  • Treatment Used: Surgery, Bisphosphonates, and TNFa-Inhibitors
  • Number of Patients: 0
  • Published —
This study compared the treatment outcomes of spinal chronic non-bacterial osteomyelitis (CNO) in children.
Clinical Trial
  • Status: Recruiting
  • Intervention Type: Drug
  • Participants: 2000
  • Start Date: August 1, 2018
CHronic Nonbacterial Osteomyelitis International Registry (CHOIR)
Clinical Trial
  • Status: Recruiting
  • Phase: N/A
  • Intervention Type: Diagnostic Test
  • Participants: 20
  • Start Date: November 1, 2015
Chronic Recurrent Multifocal Osteomyelitis - Search for a Bacterial Cause and Improving Imaging With PET/MRI