Whole-body MRI in Pediatric Chronic Recurrent Multifocal Osteomyelitis Patients

Congress:

ECR 2020

Poster Number:

C-07861

Type:

Educational Exhibit

Keywords:

Musculoskeletal, Extremities, Musculoskeletal bone, Paediatric, MR, Localisation, Inflammation, Retrospective, Observational, Performed at one institution

Authors:

I. Capaldo¹, R. Cuocolo², L. Ugga³, L. Ginolfi⁴, F. Orlando², F. Ginolfi⁴, M. Alessio², A. Brunetti¹; ¹Napoli/IT, ²Naples/IT, ³Scafati/IT, ⁴Caserta/IT

DOI:

10.26044/ecr2020/C-07861

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-07861

Fig. 1: Example images of T1-weighted (left) and STIR (right) images from a whole body...

Fig. 2: Axial STIR MR image depicting bilateral lesions located in the proximal femur.

Fig. 3: Axial T1-weigthed MR image depicting bilateral lesions located in the proximal...

Fig. 4: Coronal STIR (left) and T1-weighted (right) images depicting a lesion located...

Learning objectives

The aim of this study was to evaluate imaging signs of chronic recurrent multifocal osteomyelitis (CRMO) in MRI, including whole-body sequences.

Background

CRMO is an idiopathic auto-inflammatory disease characterized by remitting and relapsing musculoskeletal pain with a cronic evolution, secondary to sterile osseous inflammation. It primarily affects children and adolescents (onset at 9-14 years of age, F>M) and can substantially impair patient quality of life. It remains poorly recognized and its prevalence is probably underestimated. Muscoloskeletal symptoms consist of pain, bone and soft tissue edema and functional limitation with variable duration, all typically with multiple localizations.

Findings and procedure details

We retrospectively evaluated all pediatric patients with clinical complaints of articular pain between January 2010 and October 2018 (n=841). We excluded patients without CRMO diagnosis clinical confirmation or who did not undergo MRI exams at our Institution. The imaging protocol consisted of whole-body MRI examinations, with TSE T1w and STIR sequences (Figure1), and/or acquisitions of specific regions of clinical interest, with TSE T1w, TSE DPw and STIR sequences. The final population included 13 patients (6 female, 7 male) with an average age at the time...

Conclusion

MRI has a high sensibility to CRMO lesions, especially with whole-body STIR sequences, it may be useful in the detection of asymptomatic lesions and it also helps avoiding radiation exposure in pediatric patients. Furthermore, the correct identification of its imaging and clinical features may help in avoiding unnecessary invasive procedures and long-term antibiotic treatment in affected patients.

Personal information and conflict of interest

R. Cuocolo; Naples/IT - nothing to disclose I. Capaldo; Naples/IT - nothing to disclose L. Ugga; Scafati/IT - nothing to disclose L. Ginolfi; Caserta/IT - nothing to disclose F. Orlando; Naples/IT - nothing to disclose F. Ginolfi; Caserta/IT - nothing to disclose M. Alessio; Naples/IT - nothing to disclose A. Brunetti; Naples/IT - nothing to disclose

References

Falip C, Alison M,Boutry N, Job-Deslandre C, Cotten A, Azoulay R, Adamsbaum C. Chronic recurrent multifocal osteomyelitis (CRMO): a longitudinal case series review. Pediatr Radiol. 2013 Mar;43(3):355-752. Khanna G, Sato TS, Ferguson P. Imaging of chronic recurrent multifocalosteomyelitis. Radiographics. 2009 Jul-Aug;29(4):1159-773. Fritz J, Tzaribatchev N, Claussen CD, Carrino JA, Horger MS. Chronic recurrent multifocal osteomyelitis: comparison of whole-body MR imaging with radiography and correlation with clinical and laboratory data. Radiology. 2009 Sep;252(3):842-514. Iyer RS, Thapa MM, Chew FS. Chronic recurrent multifocal osteomyelitis: review. AJR Am...