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  3. Chronic recurrent multifocal osteomyelitis
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Chronic recurrent multifocal osteomyelitis


Title




Other Names:
CRMO; Multifocal osteomyelitis, chronic; Chronic multifocal osteomyelitis; CRMO; Multifocal osteomyelitis, chronic; Chronic multifocal osteomyelitis; CMO; Chronic nonbacterial osteomyelitis/Chronic recurrent multifocal osteomyelitis; CNO/CRMO See More
Categories:
Musculoskeletal Diseases; Skin Diseases

Summary Summary


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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.[1][2][3]
Last updated: 12/15/2020

Symptoms Symptoms


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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.[1][2][3]
Last updated: 12/15/2020

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Showing of 28 |
Medical Terms Other Names
Learn More:
HPO ID
80%-99% of people have these symptoms
Bone pain 0002653
Hyperostosis
Bone overgrowth
0100774
Osteomyelitis
Bone infection
0002754
30%-79% of people have these symptoms
Abnormal vertebral morphology 0003468
Abnormality of epiphysis morphology
Abnormal shape of end part of bone
0005930
Abnormality of the metaphysis
Abnormality of the wide portion of a long bone
0000944
Arthritis
Joint inflammation
0001369
Craniofacial osteosclerosis 0005464
Edema
Fluid retention
Water retention
[ more ]
0000969
Elevated C-reactive protein level 0011227
Elevated erythrocyte sedimentation rate
High ESR
0003565
Fatigue
Tired
Tiredness
[ more ]
0012378
Osteolysis
Breakdown of bone
0002797
Poor appetite
Decreased appetite
0004396
Weight loss 0001824
5%-29% of people have these symptoms
Abnormality of the sacroiliac joint 0100781
Acne 0001061
Anemia
Low number of red blood cells or hemoglobin
0001903
Cranial nerve paralysis 0006824
Fever 0001945
Inflammation of the large intestine 0002037
Palmoplantar pustulosis 0100847
Pruritus
Itching
Itchy skin
Skin itching
[ more ]
0000989
Psoriasiform dermatitis 0003765
Scoliosis 0002650
Skin rash 0000988
Vasculitis
Inflammation of blood vessel
0002633
Percent of people who have these symptoms is not available through HPO
Autosomal recessive inheritance 0000007
Showing of 28 |
Do you have more information about symptoms of this disease? We want to hear from you.
Last updated: 2/1/2021

Cause Cause


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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.[1] 
Last updated: 12/15/2020

Diagnosis Diagnosis


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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.[1][2]
Last updated: 12/15/2020

Treatment Treatment


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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.[1][3]
Last updated: 12/15/2020

Statistics Statistics


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It can be difficult to estimate the exact number of people affected by a rare condition. Some people may go undiagnosed or may be diagnosed incorrectly. Others may not seek medical care. The following estimates are based on the best information available in the scientific literature. These estimates can change based on new information.

It has been estimated that about 1-2 people in 1,000,000 has chronic recurrent multifocal osteomyelitis. The exact number is unknown. Females tend to be affected more often than males.[2][4]
Last updated: 12/15/2020
Do you have updated information on this disease? We want to hear from you.

Find a Specialist Find a Specialist


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If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

  • To find a medical professional who specializes in genetics, you can ask your doctor for a referral or you can search for one yourself. Online directories are provided by the American College of Medical Genetics and the National Society of Genetic Counselors. If you need additional help, contact a GARD Information Specialist. You can also learn more about genetic consultations from MedlinePlus Genetics.

Related Diseases Related Diseases


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Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Differential diagnosis includes mainly acute or subacute bacterial osteomyelitis, juvenile idiopathic arthritis, hypophosphatasia, Langerhans cell histiocytosis, and malignancies like osteosarcoma, Ewing sarcoma, neuroblastoma, rhabdomyosarcoma, leukemia, and lymphoma. Rare monogenetic syndromes with CNO/CRMO as a component must also be excluded, such as Majeed syndrome, PAPA syndrome and DIRA syndrome (sterile multifocal osteomyelitis with periostitis and pustulosis).
Visit the Orphanet disease page for more information.

Research Research


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Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • Orphanet lists European clinical trials, research studies, and patient registries enrolling people with this condition. 

Organizations Organizations


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Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

  • CRMO Foundation
    2827 Sunset View Drive
    Fort Collins, CO 80528
    E-mail: https://crmofoundation.org/contact-us/
    Website: https://crmofoundation.org/
  • FMF & AID Global Association
    Schüracherstrasse 25a
    8306 Brüttisellen
    Switzerland
    Telephone: +41 76 415 4010
    E-mail: info@fmfandaid.org
    Website: https://www.fmfandaid.org/

Organizations Providing General Support

  • American Autoimmune Related Diseases Association (AARDA)
    19176 Hall Road, Suite 130
    Clinton Township, MI 48038
    Toll-free: 800-598-4668
    Telephone: 586-776-3900
    Fax: 586-776-3903
    E-mail: aarda@aarda.org
    Website: https://www.aarda.org/
Do you know of an organization? We want to hear from you.

Learn More Learn More


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These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

In-Depth Information

  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Chronic recurrent multifocal osteomyelitis. Click on the link to view a sample search on this topic.

GARD Answers GARD Answers


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Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

Have a question? Contact a GARD Information Specialist.

References References


  1. Hofmann SR, Kaplusch F, Girschick HJ, Morbach H, Pablik J, Ferguson PJ, et al. Chronic Recurrent Multifocal Osteomyelitis (CRMO): Presentation, Pathogenesis, and Treatment. Curr Osteoporos Rep. Dec 2017; 15(6):542-554. https://pubmed.ncbi.nlm.nih.gov/29080202/.
  2. Buch K, Thuesen ACB, Brøns C, Schwarz P. Chronic Non-bacterial Osteomyelitis: A Review. Calcif Tissue Int. May 2019; 104(5):544-553. https://pubmed.ncbi.nlm.nih.gov/30456556/.
  3. Girschick H, Finetti M, Orlando F, Schalm S, Insalaco A, Ganser G, et al. The multifaceted presentation of chronic recurrent multifocal osteomyelitis: a series of 486 cases from the Eurofever international registry.. Rheumatology (Oxford). Jul 1, 2018; 57(7):1203-1211. https://pubmed.ncbi.nlm.nih.gov/29596638/.
  4. Zhao Y, Ferguson PJ. Chronic Nonbacterial Osteomyelitis and Chronic Recurrent Multifocal Osteomyelitis in Children. Pediatr Clin North Am. Aug 2018; 65(4):783-800. https://pubmed.ncbi.nlm.nih.gov/30031498/.
Do you know of a review article? We want to hear from you.
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rare disease research!
You can help advance rare disease research!
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