Osteomielite focal recorrente

Dentomaxillofacial Radiology (2010) 39, 184–190 ’ 2010 The British Institute of Radiology http://dmfr.birjournals.org

CASE REPORT

Chronic recurrent multifocal osteomyelitis involving the mandible: case reports and review of the literature
PAJ Monsour* and JB Dalton
The University of Queensland, School of Dentistry, Brisbane, Australia

Chronic recurrent multifocal osteomyelitis (CRMO) is an aseptic inflammatory disorder of unknown cause occurring in children and adolescents. It is characterized by multifocal bone lesions with pain and swelling recurring over months to years. Lesions usually involve the metaphyses of the long bones and involvement of the jaw is rare. The clinical presentation, radiographic appearance and histology of a case of CRMO involving the mandible in an 8year-old girl are documented. The radiographic appearance of another three cases is also described. Dentomaxillofacial Radiology (2010) 39, 184–190. doi: 10.1259/dmfr/23060413 Keywords: chronic recurrent multifocal osteomyelitis; mandible; children; computed tomography

Introduction Chronic recurrent multifocal osteomyelitis (CRMO) is an uncommon aseptic inflammatory disorder. It is characterized by bone lesions with pain and swelling with periods of exacerbation and improvement in different locations over several months to years. The aetiology of the condition is unknown.1,2 It is traditionally thought to affect children and adolescents.1 The current opinion is that CRMO is the paediatric and most severe form of SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis).3,4 The disease was first described by Giedion et al in 19725 and the term chronic recurrent multifocal osteomyelitis was coined by Bjorksten et al.2 It affects females four times more than males,1 and has a median age of onset of around 9years-old.1,6,7 The median duration of disease activity is 5 years.6,8 Lesions are most commonly found in the metaphyses of the long bones and involvement of the