Chronic recurrent multifocal osteomyelitis (CRMO)CChronic recurrent multifocal osteomyelitis (CRMO)Chronic recurrent multifocal osteomyelitis (CRMO)EnglishRheumatologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Back;Pelvis;Arm;LegsImmune systemConditions and diseasesCaregivers Adult (19+)NA2010-12-15T05:00:00ZRonald M. Laxer, MDCM, FRCPC7.0000000000000062.0000000000000790.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Information about an inflammatory disease called chronic recurrent multifocal osteomyelitis which causes pain and swelling in the bones.</p><h2>What is chronic recurrent multifocal osteomyelitis?</h2> <p>Chronic recurrent multifocal osteomyelitis (CRMO) involves inflammation of the bone.</p> <p>Usually, inflammation is a normal process. It causes pain, redness and swelling. It is the way our immune system protects itself from infection and germs. In CRMO, however, there is no infection. Instead, the immune system wrongly attacks normal bone. This causes inflammation.</p> <p>CRMO is slightly more common in girls than boys. It usually starts around the ages of eight to 14 years.</p><h2>Key points</h2> <ul> <li>CRMO causes bone pain and swelling.</li> <li>Some children will have a few attacks. Others may have many attacks of bone inflammation.</li> <li>CRMO can be treated with medications.<br></li> </ul><h2>Signs and symptoms of CRMO</h2><p>Most often there is pain and swelling of the long bones. There may be one or many sites involved. The most commonly affected areas are near the knee, ankle or wrist. Bones of the back (vertebrae), pelvis and collarbone can also be involved. The areas may be red, warm to touch and difficult to move. Fever may be present with the bone inflammation. Attacks may last a few weeks to months. Treatment can help reduce the length of the attack.</p> <figure class="asset-c-100"> <span class="asset-image-title">How CRMO affects bones</span> <img src="https://assets.aboutkidshealth.ca/akhassets/CRMO_xray_MED_ILL_EN.png" alt="" /> <figcaption class="asset-image-caption">CRMO causes inflammation in bones. In the early phase, portions of bone may be destroyed. Later on as part of the healing process, the bone thickens. The thickening is seen as the whiter and thicker bone on an X-ray.</figcaption> </figure><h2>Causes of CRMO</h2> <p>We do not know the cause of CRMO. Sometimes children with other diseases such as bowel inflammation (colitis) or psoriasis (a skin condition) also develop CRMO. Since the other diseases seem to run in families, CRMO may also be genetic. Researchers are looking into this.</p><h2>Diagnosis of CRMO</h2> <p>CRMO is a diagnosis of exclusion. This means that other diseases must be excluded before the diagnosis can be made. Many tests are often required. These include blood tests, X-rays, bone scans, MRI and often a bone biopsy. </p><h2>Treatment of CRMO </h2> <p>The goals for treatment are to:</p> <ul> <li>reduce pain</li> <li>improve the ability to move</li> <li>allow the child to lead a normal life</li> </ul> <p>Most attacks of CRMO can be managed with nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines are taken by mouth. They are called the first line of treatment. The two most common NSAIDs are <a href="/Article?contentid=198&language=English">naproxen</a> and indomethacin.</p> <p>If NSAIDs are not effective, there are other drugs called second line treatments. These include:</p> <ul> <li><a href="/Article?contentid=111&language=English">corticosteroids</a> (prednisone)</li> <li>bisphosphonates (<a href="/Article?contentid=209&language=English">pamidronate</a>)</li> <li>biologics (etanercept, infliximab, <a href="/Article?contentid=66&language=English">adalimumab</a>, anakinra)</li> </ul> <p>Studies are being done to determine the best second line treatment. </p> <h2>How your health care team can help </h2> <p>Medications can help. So can other types of treatment.</p> <p>Physiotherapists help keep the muscles strong and the joints moving properly. Occupational therapists help make daily life easier. They may suggest changes at school or at home. A social worker, nurse or child life specialist can help your child cope with the emotional challenges of having a chronic illness.</p>
Ostéomyélite multifocale chronique récurrente (OMCR)OOstéomyélite multifocale chronique récurrente (OMCR)Chronic recurrent multifocal osteomyelitis (CRMO)FrenchRheumatologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Back;Pelvis;Arm;LegsImmune systemConditions and diseasesCaregivers Adult (19+)NA2010-12-15T05:00:00ZRonald M. Laxer, MDCM, FRCPC7.0000000000000062.0000000000000790.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Information au sujet d’une maladie inflammatoire appelée ostéomyélite multifocale chronique récurrente, qui cause une douleur et une enflure dans les os.</p><h2>Qu’est-ce que l’ostéomyélite multifocale chronique récurrente?</h2> <p>L’ostéomyélite multifocale chronique récurrente (OMCR) implique une inflammation des os.</p> <p>Habituellement, l’inflammation est un processus normal. Elle cause de la douleur, des rougeurs et une enflure. Il s’agit de la façon dont notre système immunitaire se protège contre les infections et les germes. Dans l’OMCR, cependant, il n’y a pas d’infection. Au contraire, le système immunitaire attaque par erreur les os normaux et entraîne ainsi une inflammation.</p> <p>L’OMCR s'observe légèrement plus souvent chez les filles que chez les garçons. Elle se manifeste la plupart du temps entre 8 et 14 ans.</p><h2>À retenir</h2> <ul> <li>L’OMCR cause une douleur et une enflure des os.</li> <li>Certains enfants auront quelques crises. D’autres pourraient avoir de nombreuses crises d’inflammation des os.</li> <li>On peut traiter l’OMCR avec des médicaments.</li> </ul><h2>Signes et symptômes de l’OMCR</h2> <p>Habituellement, la maladie se manifeste par une douleur et une enflure des os longs. Un ou plusieurs sites peuvent être touchés. Les régions les plus souvent touchées sont le genou, la cheville ou le poignet. Les os du dos (vertèbres), du bassin et de la clavicule peuvent aussi être touchés. Les régions peuvent être rouges, chaudes au toucher et difficiles à bouger. Une fièvre peut accompagner l’inflammation des os. Les attaques peuvent durer quelques semaines voire des mois. Le traitement peut aider à réduire la durée de l’attaque.</p> <figure> <span class="asset-image-title">Effet de l'ostéomyélite multifocale récurrente chronique (OMRC) sur les os</span> <img src="https://assets.aboutkidshealth.ca/akhassets/CRMO_xray_MED_ILL_FR.png" alt="" /> <figcaption class="asset-image-caption">L'OMRC provoque une inflammation des os. Dans la phase précoce, des parties des os peuvent être détruites. Plus tard, pendant la guérison, l'os s'épaissit. Cet épaississement s'observe par des os plus blancs et épais sur une radiographie.</figcaption> </figure><p>Nous ne savons pas ce qui cause l’OMCR. Parfois, les enfants atteints d’autres maladies comme une inflammation intestinale (colite) ou le psoriasis (une maladie de la peau) développent aussi l’OMCR. Étant donné que les autres maladies semblent être courantes dans les familles, l’OMRC pourrait aussi être génétique. Les chercheurs étudient cette question.</p><h2>Diagnostic de l’OMCR</h2> <p>L’OMCR est un « diagnostic par élimination ». Cela signifie que d’autres maladies doivent être exclues avant de pouvoir établir un diagnostic. Il faut souvent effectuer bon nombre de tests. Il peut s’agir d’analyses de sang, de radiographies aux rayons X, de scintigraphies osseuses, d’IRM et, souvent, d’une biopsie osseuse.</p><h2>Traitement de l’OMCR </h2> <p>Les objectifs du traitement sont les suivants :</p> <ul> <li>atténuer la douleur;</li> <li>améliorer la capacité à se déplacer;</li> <li>permettre à l’enfant de mener une vie normale.</li> </ul> <p>La plupart des attaques de l’OMCR peuvent être traitées avec des anti-­inflammatoires non stéroïdiens (AINS). Ces médicaments sont pris oralement (avalés). C’est ce que l’on appelle un traitement de première ligne. Les deux AINS les plus courants sont le naproxène et l'indométacine.</p> <p>Si les AINS ne sont pas efficaces, il existe d’autres médicaments que l’on appelle des traitements de deuxième ligne. Ces traitements comprennent, sans toutefois s’y limiter, les suivants :</p> <ul> <li>corticostéroïdes (prednisone);</li> <li>bisphosphonates (pamidronate);</li> <li>médicaments biologiques (étanercept, infliximab, adalimumab, anakinra).</li> </ul> <p>Des études sont en cours afin de déterminer le meilleur traitement de deuxième ligne.</p> <h2>Façon dont votre équipe de soins de santé peut vous aider</h2> <p>Des médicaments peuvent aider. Il existe aussi d’autres types de traitement. Les physiothérapeutes aident à garder les muscles forts et à faire bien fonctionner les articulations. </p> <p>Les ergothérapeutes aident à rendre la vie quotidienne plus facile. Ils peuvent suggérer des changements à l’école ou à la maison. Un travailleur social, un infirmier ou un éducateur en milieu pédiatrique peut aider votre enfant à composer avec les difficultés émotionnelles liées au fait d’avoir une maladie chronique.</p>

 

 

Chronic recurrent multifocal osteomyelitis (CRMO)919.000000000000Chronic recurrent multifocal osteomyelitis (CRMO)Chronic recurrent multifocal osteomyelitis (CRMO)CEnglishRheumatologySchool age child (5-8 years);Pre-teen (9-12 years);Teen (13-18 years)Back;Pelvis;Arm;LegsImmune systemConditions and diseasesCaregivers Adult (19+)NA2010-12-15T05:00:00ZRonald M. Laxer, MDCM, FRCPC7.0000000000000062.0000000000000790.000000000000Health (A-Z) - ConditionsHealth A-Z<p>Information about an inflammatory disease called chronic recurrent multifocal osteomyelitis which causes pain and swelling in the bones.</p><h2>What is chronic recurrent multifocal osteomyelitis?</h2> <p>Chronic recurrent multifocal osteomyelitis (CRMO) involves inflammation of the bone.</p> <p>Usually, inflammation is a normal process. It causes pain, redness and swelling. It is the way our immune system protects itself from infection and germs. In CRMO, however, there is no infection. Instead, the immune system wrongly attacks normal bone. This causes inflammation.</p> <p>CRMO is slightly more common in girls than boys. It usually starts around the ages of eight to 14 years.</p><h2>Key points</h2> <ul> <li>CRMO causes bone pain and swelling.</li> <li>Some children will have a few attacks. Others may have many attacks of bone inflammation.</li> <li>CRMO can be treated with medications.<br></li> </ul><h2>Signs and symptoms of CRMO</h2><p>Most often there is pain and swelling of the long bones. There may be one or many sites involved. The most commonly affected areas are near the knee, ankle or wrist. Bones of the back (vertebrae), pelvis and collarbone can also be involved. The areas may be red, warm to touch and difficult to move. Fever may be present with the bone inflammation. Attacks may last a few weeks to months. Treatment can help reduce the length of the attack.</p> <figure class="asset-c-100"> <span class="asset-image-title">How CRMO affects bones</span> <img src="https://assets.aboutkidshealth.ca/akhassets/CRMO_xray_MED_ILL_EN.png" alt="" /> <figcaption class="asset-image-caption">CRMO causes inflammation in bones. In the early phase, portions of bone may be destroyed. Later on as part of the healing process, the bone thickens. The thickening is seen as the whiter and thicker bone on an X-ray.</figcaption> </figure><h2>Causes of CRMO</h2> <p>We do not know the cause of CRMO. Sometimes children with other diseases such as bowel inflammation (colitis) or psoriasis (a skin condition) also develop CRMO. Since the other diseases seem to run in families, CRMO may also be genetic. Researchers are looking into this.</p><h2>Diagnosis of CRMO</h2> <p>CRMO is a diagnosis of exclusion. This means that other diseases must be excluded before the diagnosis can be made. Many tests are often required. These include blood tests, X-rays, bone scans, MRI and often a bone biopsy. </p><h2>Treatment of CRMO </h2> <p>The goals for treatment are to:</p> <ul> <li>reduce pain</li> <li>improve the ability to move</li> <li>allow the child to lead a normal life</li> </ul> <p>Most attacks of CRMO can be managed with nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines are taken by mouth. They are called the first line of treatment. The two most common NSAIDs are <a href="/Article?contentid=198&language=English">naproxen</a> and indomethacin.</p> <p>If NSAIDs are not effective, there are other drugs called second line treatments. These include:</p> <ul> <li><a href="/Article?contentid=111&language=English">corticosteroids</a> (prednisone)</li> <li>bisphosphonates (<a href="/Article?contentid=209&language=English">pamidronate</a>)</li> <li>biologics (etanercept, infliximab, <a href="/Article?contentid=66&language=English">adalimumab</a>, anakinra)</li> </ul> <p>Studies are being done to determine the best second line treatment. </p> <h2>How your health care team can help </h2> <p>Medications can help. So can other types of treatment.</p> <p>Physiotherapists help keep the muscles strong and the joints moving properly. Occupational therapists help make daily life easier. They may suggest changes at school or at home. A social worker, nurse or child life specialist can help your child cope with the emotional challenges of having a chronic illness.</p><h2>Outlook for children with CRMO</h2> <p>Attacks may come and go over several years. Fortunately, attacks usually decrease over time. Studies have shown that children with CRMO can safely take part in normal physical activities. They can usually attend school.</p> <p>Regular clinic visits help determine the amount of bone inflammation. These visits can also help determine whether your child needs more tests and medications. If other diseases are found, a referral will be made to the appropriate specialist. </p> <h3>School, gym, and other activities</h3> <p>If your child is having an attack of CRMO, it may be difficult to do gym class and sports. Most children can figure out what they are able to do. You can help by letting their teachers and coaches know. </p> <p>Sometimes the pain may make it difficult for children to concentrate. This can make going to school a challenge. Medications will usually enable a child with CRMO to go to school. Let the school know about your child's condition. They can make accommodations if needed.</p> <h2>Follow-up care </h2> <p>Your child will be referred to a rheumatology clinic for follow-up care. Usually, a rheumatology clinic will have a team of doctors and nurses who have experience treating children with CRMO. </p> <p>Other members of the rheumatology team may include:</p> <ul> <li>a physical therapist and an occupational therapist, to help with your child's movement of joints and teach your child different ways of doing things<br></li> <li>a social worker and a child life specialist to help with any emotional and behavioural problems that might result from the disease<br></li> <li>a dietitian to help with your child's diet and nutrition.<br></li> </ul> <p>Your child may need a blood test during a clinic visit. This will help doctors monitor the disease. They will also check for side effects of the medicine your child is taking. If your child needs to prepare for clinic visits in any other way, the rheumatology team will tell you before the visit. </p> <p>After you have met the rheumatology team, you will know more about how to care for your child. They will tell you how to plan for future clinic visits. </p><img alt="" src="https://assets.aboutkidshealth.ca/AKHAssets/chronic_recurrent_multifocal_osteomyelitis.jpg" style="BORDER:0px solid;" />https://assets.aboutkidshealth.ca/AKHAssets/chronic_recurrent_multifocal_osteomyelitis.jpgChronic recurrent multifocal osteomyelitis (CRMO)

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