G357 Chronic recurrent multifocal osteomyelitis (crmo): the value of whole body mri demonstrated by a series of 13 adult and 34 paediatric patients

Abstract

AimTo assess the role of whole-body MRI (WB MRI) in the diagnosis and management of patients with Chronic Recurrent Multifocal Osteomyelitis (CRMO). CRMO is a benign and non-infective autoinflammatory bone disorder characterised by multiple and recurrent inflammatory bone lesions. No universal diagnostic criteria exist. MethodsRetrospective review of CRMO cases diagnosed at this hospital between 2008 to 2014. Cases were identified from patient records, and clinical information was collated from radiology and histopathology records and individual case notes. ResultsForty seven CRMO patients were identified who had had WB MRI, of these 34 were paediatric patients up to the age of 18 years. The number of WB MRI scans per case ranged from 1 to 5 [mean 1.5]. WB MRI identified multifocal lesions in 30 patients. The clavicle, tibia and femur were most frequently involved. All cases were managed with non-steroidal anti-inflammatory medication or bisphosphonates. No children required steroid or anti-TNF treatment or surgical resection. ConclusionsIn the absence of specific diagnostic criteria, WB MRI in combination with clinical assessment can aid in the diagnosis of CRMO. WB MRI has almost entirely replaced bone biopsy in the diagnosis of CRMO at our institution.