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Case report
Radiographic changes of chronic recurrent multifocal osteomyelitis that persisted into adulthood
  1. Andrew Bergeron,
  2. Thomas Lewellen and
  3. Bhavesh Joshi
  1. Clinical Medicine, New York Institute of Technology College of Osteopathic Medicine at Arkansas State University, Jonesboro, Arkansas, USA
  1. Correspondence to Dr Bhavesh Joshi; bjoshi02{at}


Chronic recurrent multifocal osteomyelitis (CRMO) is a rare non-infectious autoinflammatory disorder typically seen in young women. We describe the case of a young man who presented at 13 years of age with pain in the tibia, humerus, clavicle and hip. Worsening of the condition through clinical presentation and radiographic imaging was observed over 10 years. Radiographic imaging initially showed some sclerotic changes, but worsened to osteolytic lesions of the proximal tibia, elevation of the lateral cortex and thickening of the anterior cortex. Bone biopsy of his right anterior proximal tibia showed no infection or neoplasia. But, laboratory results showed elevation of inflammatory markers such as erythrocyte sedimentation rate or C-reactive protein. The patient was diagnosed with CRMO and treated with antibiotics for suspicion of chronic bacterial osteomyelitis. Chronic bone pain, abnormal imaging and elevation of inflammatory markers suggesting that chronic bacterial osteomyelitis can lead to difficulties with the diagnosis of CRMO.

  • musculoskeletal and joint disorders
  • drugs: musculoskeletal and joint diseases
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  • Contributors AB, TL and BJ participated in the management of the patient, obtained clinical data, reviewed the literature and drafted the manuscript. AB helped to draft the manuscript, and critically revised the final manuscript. All the authors have read and given final approval to the manuscript submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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