Chronic Recurrent Multifocal Osteomyelitis (CRMO)

Overview

Chronic recurrent multifocal osteomyelitis, also known as chronic nonbacterial osteomyelitis, is an autoinflammatory condition that causes bone pain from inflammation rather than from an actual infection. It typically begins around ages 9 to 10 and is diagnosed more often in girls than boys, and in some cases it can run in families. Along with bone tenderness and pain that can make a child avoid using a limb, it can also cause joint swelling and fatigue.

Questions to Ask Your Doctor

• What imaging or tests, such as X-rays, MRI, or a bone biopsy, confirmed this is CRMO rather than a bone infection?
• Why does treatment usually start with NSAIDs, and how will we know if we need to move on to methotrexate or a biologic medication?
• If a biologic medication is recommended, what screening, like a TB test, and ongoing monitoring will my child need?
• How will we track whether the bone inflammation is improving, and how often will follow-up imaging be needed?
• What's the outlook for my child — is remission possible, or should we plan for this as a long-term condition to manage?

Getting Care

A pediatric rheumatologist typically diagnoses and manages CRMO, coordinating imaging and, when needed, biologic therapy. Seek care sooner if bone pain suddenly worsens, comes with fever, or your child starts refusing to bear weight on a limb, since these can also be signs of an actual bone infection that needs prompt evaluation.

Source: https://rheumatology.org/patients/chronic-recurrent-multifocal-osteomyelitis-crmo