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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2008 December;59(6):373-7
Chronic recurrent multifocal osteomyelitis: diagnostic problems and treatment
Cussotti S., Matteoni E., Pisano G., Paonessa M.
Unità Operativa d’Ateneo di Ortopedia e Traumatologia Ospedale Regina Margherita Torino A.O. OIRM - S. Anna, Torino, Italia
The authors describe three clinical cases of chronic recurrent multifocal osteomyelitis, a rare bony inflammatory affection typical of childhood. In 1976 Probst defined such pathology, but today its etiology is still discussed. Multifocal osteomyelitis is characterized by multiple non-specific osteitis located on the clavicle, the rachis and the metaphysis of the long bones, in absence of suppurative processes and of fistulas. The inflammation indexes are low and the bacterial and viral examinations are negative. The diagnosis is based on the histological examination of at least two biopsies, useful to detect subacute osteitis and a negative culture examination. The evolution is generally characterized by remission and relapse phases that last for years, with a final recovery. Therefore, a correct differential diagnosis is important to avoid the young patients to undergo antibiotic therapies or radical and incongruous surgical treatments.