Background/Purpose: CRMO is an autoinflammatory bone disease which has a recurrent bone pain as a symptom. It causes problems in various organs, including joints, skin, and intestines, and causes complications due to persistent pain, bone weakness, and deformation. However, there are difficulties in diagnosis and treatment because of the lack of information due to its low incidence. The purpose of this study is to identify the clinical features and prognosis of CRMO in children and adolescents.

Methods: We retrospectively analyzed the medical records of pediatric CRMO patients who were diagnosed in Seoul National University Children’s Hospital between January 2004 to December 2022.

Results: Among 58 patients, male were 62.1% (n=36), the age at diagnosis was 11.13.4 years, and the follow-up duration was 34.540.1 months. The duration from the onset of symptoms to the visit to the hospital was 12.1 16.3 months, and the first symptom site was the knee (n = 34), followed by the ankle (n = 17) and hip (n = 15), with the involvement of average 1.8 1.1 bony sites. Accompanying symptoms were in order of trauma history (n=18), fever (n=16), and morning symptoms (n=7). At the time of the first diagnosis, blood tests showed an average ESR of 30.531.8 mm/h and CRP of 1.94.7 mg/dL. Patients were treated with NSAIDs, DMARDs, bisphosphonates, biologics, etc. The average duration of usage was 18.728.5 months for NSAIDs, 10.824.8 months for DMARDs, and 7.822.0 months for steroids. Bisphosphonate was used by 1 patient and biologics was used by 7 patients. At the final follow-up, 48.3% (n=28) had a clinical improvement, 31.0% (n=18) had improved MRI results, and 32.8% (n=19) had improved blood tests. Complications such as genu varum and leg length discrepancy were found in 12 patients, and 5 of them underwent surgery. Nine out of 28 people, who measured initial and final height, showed a decreased final height percentile compared to the initial height percentile.

Conclusion: CRMO is a rare inflammatory disease that occurs in children and adolescents. Therefore, it is difficult to understand its clinical features, diagnosis, treatment, and prognosis. The purpose of this study is to improve the understanding of the disease by identifying the clinical characteristics of Korean pediatric patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-characteristics-of-chronic-recurrent-multifocal-osteomyelitis-or-chronic-nonbacterial-osteomyelitis-in-pediatrics-single-center-study-in-korea/