Chronic Recurrent Multifocal Osteomyelitis

CNO/CRMO is an underrecognized autoinflammatory disorder of the skeletal system resulting from immune dysregulation. Its vague symptoms often result in a delay in diag-nosis for days to years, and because of the lack of accepted diagnostic criteria or spe-cific biomarkers, CRMO remains a diagnosis of exclusion. Untreated CRMO has the potential to cause chronic, debilitating skeletal deformities with neurologic manifesta-tions, arthritis, and chronic pain. Diagnosis requires MRI of the symptomatic area as well as WB-MRI for identification of clinically silent lesions. Treatment is primarily through antiinflammatory medications, with NSAIDs comprising first-line therapy and DMARDs used for disease relapse. Bisphosphonates are used when necessary to pre-vent spinal deformities and growth abnormalities. Early diagnosis and treatment are paramount to lessen disease severity, and involvement of child psychology can be helpful to provide psychosocial support to children with this chronic disease.