Chronic Recurrent Multifocal Osteomyelitis


Sagittal T1WI MR shows multiple areas of ↓ signal in multiple vertebral bodies without paraspinal or epidural soft tissue. Compression fractures are present at multiple levels image, some with normal marrow due to old lesions image.



image
Sagittal STIR MR shows increased signal lesions within multiple vertebral bodies. Multiple pathologic compression fractures are present. Intervening disc signal is normal, and there is no paraspinal abnormality.


TERMINOLOGY


Abbreviations




• Chronic recurrent multifocal osteomyelitis (CRMO)


Synonyms




• Chronic sclerosing osteomyelitis, condensing osteitis, primary chronic osteomyelitis, pustulotic arthrosteitis, lymphoplasmacellular osteomyelitis

• Autosomal recessive syndromic form of disease is Majeed syndrome (OMIM 609628)


Definitions




• Autoinflammatory disorder of bone with fever, multifocal painful nonpyogenic bone lesions, relapsing and remitting course in children and adolescents

• Adult disease is SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis)


IMAGING


General Features




• Best diagnostic clue
image Involvement of multiple noncontiguous vertebral bodies with sparing of intervertebral disc

• Location
image Spine involvement uncommon (3% of lesions)
– Most common site complicated by pathologic fracture

image Thoracic most common spine site > lumbar > cervical


Radiographic Findings




• Radiography
image Loss of vertebral body height

image Lytic lesions with surrounding sclerosis or purely sclerotic


MR Findings



Oct 5, 2016 | Posted by in NEUROLOGICAL IMAGING | Comments Off on Chronic Recurrent Multifocal Osteomyelitis

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