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Erschienen in: Pediatric Radiology 12/2022

07.06.2022 | Original Article

Whole-body MRI at initial presentation of pediatric chronic recurrent multifocal osteomyelitis and correlation with clinical assessment

verfasst von: Sarah J. Menashe, Ramesh S. Iyer, Anh-Vu Ngo, Natalie L. Rosenwasser, Yongdong Zhao, Ezekiel Maloney

Erschienen in: Pediatric Radiology | Ausgabe 12/2022

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Abstract

Background

Chronic recurrent multifocal osteomyelitis (CRMO) is a diagnosis of exclusion, relying heavily on whole-body magnetic resonance imaging (WB-MRI) for diagnosing and evaluating response to therapy. Information with respect to disease distribution and imaging correlation with clinical disease severity at initial presentation is lacking.

Objective

To retrospectively characterize distribution of disease on WB-MRI and to correlate imaging findings with disease severity at initial rheumatology presentation.

Materials and methods

Using a modified version of a recently devised imaging-based scoring system, we evaluated disease distribution and correlation between findings on WB-MRI and clinical disease severity in 54 patients presenting for initial evaluation of CRMO. Symptomatic lesion sites were extracted from chart review and physician global assessment was determined by the consensus of two rheumatologists.

Results

Sites of CRMO involvement evident on imaging at initial presentation had a strong predilection for the pelvis and lower extremities. There was significant correlation between the number of lesions detected on WB-MRI and total clinical severity score at initial rheumatology presentation (P<0.01). However, no other imaging parameter correlated with disease severity.

Conclusion

While the overall number of lesions identified on MRI correlates with clinical severity scores at initial imaging, other MR parameters of CRMO lesions may not be reliable indicators of disease severity at initial presentation. Further research is needed to assess whether these parameters are implicated in longitudinal disease severity or overall response to therapy.
Literatur
1.
Zurück zum Zitat Giedion A, Holthusen W, Masel LF, Vischer D (1972) Subacute and chronic “symmetrical” osteomyelitis. Ann Radiol (Paris) 15:329–342 Giedion A, Holthusen W, Masel LF, Vischer D (1972) Subacute and chronic “symmetrical” osteomyelitis. Ann Radiol (Paris) 15:329–342
2.
Zurück zum Zitat Hedrich CM, Morbach H, Reiser C, Girschick HJ (2020) New insights into adult and paediatric chronic non-bacterial osteomyelitis CNO. Curr Rheumatol Rep 22:52CrossRefPubMedPubMedCentral Hedrich CM, Morbach H, Reiser C, Girschick HJ (2020) New insights into adult and paediatric chronic non-bacterial osteomyelitis CNO. Curr Rheumatol Rep 22:52CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Fritz J (2015) The contributions of whole-body magnetic resonance imaging for the diagnosis and management of chronic recurrent multifocal osteomyelitis. J Rheumatol 42:1359–1360CrossRefPubMed Fritz J (2015) The contributions of whole-body magnetic resonance imaging for the diagnosis and management of chronic recurrent multifocal osteomyelitis. J Rheumatol 42:1359–1360CrossRefPubMed
4.
Zurück zum Zitat Oliver M, Lee TC, Halpern-Felsher B et al (2018) Disease burden and social impact of pediatric chronic nonbacterial osteomyelitis from the patient and family perspective. Pediatr Rheumatol Online J 16:78CrossRefPubMedPubMedCentral Oliver M, Lee TC, Halpern-Felsher B et al (2018) Disease burden and social impact of pediatric chronic nonbacterial osteomyelitis from the patient and family perspective. Pediatr Rheumatol Online J 16:78CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Wipff J, Costantino F, Lemelle I et al (2015) A large national cohort of French patients with chronic recurrent multifocal osteitis. Arthritis Rheumatol Hoboken NJ 67:1128–1137CrossRef Wipff J, Costantino F, Lemelle I et al (2015) A large national cohort of French patients with chronic recurrent multifocal osteitis. Arthritis Rheumatol Hoboken NJ 67:1128–1137CrossRef
6.
Zurück zum Zitat Zhao Y, Wu EY, Oliver MS et al (2018) Consensus treatment plans for chronic nonbacterial osteomyelitis refractory to nonsteroidal antiinflammatory drugs and/or with active spinal lesions. Arthritis Care Res 70:1228–1237CrossRef Zhao Y, Wu EY, Oliver MS et al (2018) Consensus treatment plans for chronic nonbacterial osteomyelitis refractory to nonsteroidal antiinflammatory drugs and/or with active spinal lesions. Arthritis Care Res 70:1228–1237CrossRef
7.
Zurück zum Zitat Khanna G, Sato TS, Ferguson P (2009) Imaging of chronic recurrent multifocal osteomyelitis. Radiographics 29:1159–1177CrossRefPubMed Khanna G, Sato TS, Ferguson P (2009) Imaging of chronic recurrent multifocal osteomyelitis. Radiographics 29:1159–1177CrossRefPubMed
8.
Zurück zum Zitat Voit AM, Arnoldi AP, Douis H et al (2015) Whole-body magnetic resonance imaging in chronic recurrent multifocal osteomyelitis: clinical longterm assessment may underestimate activity. J Rheumatol 42:1455–1462CrossRefPubMed Voit AM, Arnoldi AP, Douis H et al (2015) Whole-body magnetic resonance imaging in chronic recurrent multifocal osteomyelitis: clinical longterm assessment may underestimate activity. J Rheumatol 42:1455–1462CrossRefPubMed
9.
Zurück zum Zitat Darge K, Jaramillo D, Siegel MJ (2008) Whole-body MRI in children: current status and future applications. Eur J Radiol 68:289–298CrossRefPubMed Darge K, Jaramillo D, Siegel MJ (2008) Whole-body MRI in children: current status and future applications. Eur J Radiol 68:289–298CrossRefPubMed
10.
Zurück zum Zitat Fritz J, Tzaribatchev N, Claussen CD et al (2009) Chronic recurrent multifocal osteomyelitis: comparison of whole-body MR imaging with radiography and correlation with clinical and laboratory data. Radiology 252:842–851CrossRefPubMed Fritz J, Tzaribatchev N, Claussen CD et al (2009) Chronic recurrent multifocal osteomyelitis: comparison of whole-body MR imaging with radiography and correlation with clinical and laboratory data. Radiology 252:842–851CrossRefPubMed
11.
Zurück zum Zitat Iyer RS, Thapa MM, Chew FS (2011) Chronic recurrent multifocal osteomyelitis: review. AJR Am J Roentgenol 196:S87–S91CrossRefPubMed Iyer RS, Thapa MM, Chew FS (2011) Chronic recurrent multifocal osteomyelitis: review. AJR Am J Roentgenol 196:S87–S91CrossRefPubMed
12.
Zurück zum Zitat Falip C, Alison M, Boutry N et al (2013) Chronic recurrent multifocal osteomyelitis (CRMO): a longitudinal case series review. Pediatr Radiol 43:355–375CrossRefPubMed Falip C, Alison M, Boutry N et al (2013) Chronic recurrent multifocal osteomyelitis (CRMO): a longitudinal case series review. Pediatr Radiol 43:355–375CrossRefPubMed
13.
Zurück zum Zitat Andronikou S, Kraft JK, Offiah AC et al (2020) Whole-body MRI in the diagnosis of paediatric CNO/CRMO. Rheumatology (Oxford) 59:2671–2680CrossRef Andronikou S, Kraft JK, Offiah AC et al (2020) Whole-body MRI in the diagnosis of paediatric CNO/CRMO. Rheumatology (Oxford) 59:2671–2680CrossRef
14.
Zurück zum Zitat Andronikou S, Mendes da Costa T, Hussien M, Ramanan AV (2019) Radiological diagnosis of chronic recurrent multifocal osteomyelitis using whole-body MRI-based lesion distribution patterns. Clin Radiol 74:737.e3–737.e15CrossRef Andronikou S, Mendes da Costa T, Hussien M, Ramanan AV (2019) Radiological diagnosis of chronic recurrent multifocal osteomyelitis using whole-body MRI-based lesion distribution patterns. Clin Radiol 74:737.e3–737.e15CrossRef
15.
Zurück zum Zitat Jurik AG, Klicman RF, Simoni P et al (2018) SAPHO and CRMO: the value of imaging. Semin Musculoskelet Radiol 22:207–224CrossRefPubMed Jurik AG, Klicman RF, Simoni P et al (2018) SAPHO and CRMO: the value of imaging. Semin Musculoskelet Radiol 22:207–224CrossRefPubMed
16.
Zurück zum Zitat Arnoldi AP, Schlett CL, Douis H et al (2017) Whole-body MRI in patients with non-bacterial osteitis: radiological findings and correlation with clinical data. Eur Radiol 27:2391–2399CrossRefPubMed Arnoldi AP, Schlett CL, Douis H et al (2017) Whole-body MRI in patients with non-bacterial osteitis: radiological findings and correlation with clinical data. Eur Radiol 27:2391–2399CrossRefPubMed
17.
Zurück zum Zitat Zhao Y, Sato TS, Nielsen SM et al (2019) Development of a scoring tool for chronic nonbacterial osteomyelitis magnetic resonance imaging and evaluation of its interrater reliability. J Rheumatol 47:739–747CrossRefPubMed Zhao Y, Sato TS, Nielsen SM et al (2019) Development of a scoring tool for chronic nonbacterial osteomyelitis magnetic resonance imaging and evaluation of its interrater reliability. J Rheumatol 47:739–747CrossRefPubMed
18.
Zurück zum Zitat Capponi M, Pires Marafon D, Rivosecchi F et al (2021) Assessment of disease activity using a whole-body MRI derived radiological activity index in chronic nonbacterial osteomyelitis. Pediatr Rheumatol Online J 19:123CrossRefPubMedPubMedCentral Capponi M, Pires Marafon D, Rivosecchi F et al (2021) Assessment of disease activity using a whole-body MRI derived radiological activity index in chronic nonbacterial osteomyelitis. Pediatr Rheumatol Online J 19:123CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Sato TS, Watal P, Ferguson PJ (2020) Imaging mimics of chronic recurrent multifocal osteomyelitis: avoiding pitfalls in a diagnosis of exclusion. Pediatr Radiol 50:124–136CrossRefPubMed Sato TS, Watal P, Ferguson PJ (2020) Imaging mimics of chronic recurrent multifocal osteomyelitis: avoiding pitfalls in a diagnosis of exclusion. Pediatr Radiol 50:124–136CrossRefPubMed
20.
Zurück zum Zitat Menashe SJ, Aboughalia H, Zhao Y et al (2020) The many faces of pediatric chronic recurrent multifocal osteomyelitis (CRMO): a practical location- and case-based approach to differentiate CRMO from its mimics. J Magn Reson Imaging 54:391–400CrossRefPubMed Menashe SJ, Aboughalia H, Zhao Y et al (2020) The many faces of pediatric chronic recurrent multifocal osteomyelitis (CRMO): a practical location- and case-based approach to differentiate CRMO from its mimics. J Magn Reson Imaging 54:391–400CrossRefPubMed
21.
Zurück zum Zitat Roderick MR, Shah R, Rogers V et al (2016) Chronic recurrent multifocal osteomyelitis (CRMO) - advancing the diagnosis. Pediatr Rheumatol Online J 14:47CrossRefPubMedPubMedCentral Roderick MR, Shah R, Rogers V et al (2016) Chronic recurrent multifocal osteomyelitis (CRMO) - advancing the diagnosis. Pediatr Rheumatol Online J 14:47CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat d’Angelo P, de Horatio LT, Toma P et al (2021) Chronic nonbacterial osteomyelitis - clinical and magnetic resonance imaging features. Pediatr Radiol 51:282–288CrossRefPubMed d’Angelo P, de Horatio LT, Toma P et al (2021) Chronic nonbacterial osteomyelitis - clinical and magnetic resonance imaging features. Pediatr Radiol 51:282–288CrossRefPubMed
23.
Zurück zum Zitat Harris PA, Taylor R, Thielke R et al (2009) Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381CrossRefPubMed Harris PA, Taylor R, Thielke R et al (2009) Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381CrossRefPubMed
24.
Zurück zum Zitat Hospach T, Langendoerfer M, von Kalle T et al (2010) Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate. Eur J Pediatr 169:1105–1111CrossRefPubMed Hospach T, Langendoerfer M, von Kalle T et al (2010) Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate. Eur J Pediatr 169:1105–1111CrossRefPubMed
25.
Zurück zum Zitat Gleeson H, Wiltshire E, Briody J et al (2008) Childhood chronic recurrent multifocal osteomyelitis: pamidronate therapy decreases pain and improves vertebral shape. J Rheumatol 35:707–712PubMed Gleeson H, Wiltshire E, Briody J et al (2008) Childhood chronic recurrent multifocal osteomyelitis: pamidronate therapy decreases pain and improves vertebral shape. J Rheumatol 35:707–712PubMed
26.
Zurück zum Zitat Concha S, Hernández-Ojeda A, Contreras O et al (2020) Chronic nonbacterial osteomyelitis in children: a multicenter case series. Rheumatol Int 40:115–120CrossRefPubMed Concha S, Hernández-Ojeda A, Contreras O et al (2020) Chronic nonbacterial osteomyelitis in children: a multicenter case series. Rheumatol Int 40:115–120CrossRefPubMed
Metadaten
Titel
Whole-body MRI at initial presentation of pediatric chronic recurrent multifocal osteomyelitis and correlation with clinical assessment
verfasst von
Sarah J. Menashe
Ramesh S. Iyer
Anh-Vu Ngo
Natalie L. Rosenwasser
Yongdong Zhao
Ezekiel Maloney
Publikationsdatum
07.06.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Radiology / Ausgabe 12/2022
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-022-05388-6

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