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Chronic recurrent multifocal osteomyelitis

Chronic recurrent multifocal osteomyelitis is a bone disease.

Chronic-pain begins 3-4 weeks after onset
Recurrent-It reoccurs or returns
Multifocal-it appears in numerous parts on the skeleton
Osteomyelitis- A bone inflammatory disorder

I figured out that Osteomyelitis has been around for
a while but I am not sure how they treated it. One of
my doctors informed me that people used to think it
was just growing pains. There has been no found
difference in the bones of a CRMO patient to a normal
person. Because this disease is rare there were not
enough patients affected to prove any similarities
among them.

In case you are extremely confused on what happens to your bone
then i will attempt to explain. When germs get into your body it is
possible that they may travel down ones blood stream and attach
to the bone. Naturally, the white blood cells attack the invader to
defend your body. After a long time when the germs have been
killed, the white blood cells get confused and begin to attack the
bone instead.

So far most of the information that i have gathered
has been about the diagnosis and symptoms of CRMO.
Such as, Symptoms are pain, swelling, redness of the
site and possible fever. If a fever occurs seeing a
doctor would be very necessary. If you are beginning to worry
please don't it is a very rare disease and there are treatments
available. If your symptoms agree with this discription, please
notify a doctor instead of jumping to conclusions from this article.
Online, I found an article about CRMO written by Dr.
Girschick. Here I learned about the areas most
affected. (i.e. mandible, clavicle, femur, calcareous,
and ankle) I also learned that symptoms include;
re merging pain, local swelling, and presence of
inflammation shown by MRI. Inflammation being the
swelling of the bone The hard part is that there
is no positive or negative test to know if you have
CRMO.
Other types of Osteomyelitis (the O in CRMO) are;
Unifocal non recurrent
Unifocal recurrent
Multifocal nonrecurrent
Multifocal recurrent (CRMO)
Osteomyelitis is more common than CRMO and is an infection of the bone.
Having Osteomyelitis can lead to CRMO, this happened in my case.

In this article, the article by Dr. Girschick, I learned that
bronchial infections might be a possible trigger for
a relapse. Dr. Girschick said that, “Most number of
bone lesions ever found was 63.” Multiple lesions in one
bone is rare. When CRMO is not outgrown it shows up
as SAPHO, or acne of the skin above the affected bone. From
1991-2002, 30 kids were diagnosed. These children had
a range of 2-17 years. There were 21 girls and 9 boys.
Proving that known fact that CRMO is more common among
girls.

At the school library, I read a section in a book
about Osteomyelitis. I learned that this disease was
known since ancient times. The author of the book also
hinted that a cause might be respiratory infections, as mentioned
before. Other causes might be an open wound that exposes bone or
shatters bone. (i.e. bullet wound). Studies show that
more people were affected in places where wound care
is inadequate. This article said that to diagnose this
disease blood tests, x-rays, and biopsies are needed.
Treatments for Osteomyelitis (not CRMO) include
antibiotics, or in some cases, surgical draining.
In 2002 when i was diagnosed with Osetomyelitis,
I had to have surgery to remove the affected bone.
To prevent this disease one must seek prompt
treatment of respiratory infections, such as Strep.

When I was in Minnesota for winter break I tried to
find a book. Instead I found an article and talked to
a regents professor. The professor told me that there
were many other names for CRMO. Such as Crohn’s
disease hyperostosis and more. In 1990 they settled on
CRMO. He told me that before MRI’s, lesions showed up
on X-rays.

He also told me about treating one of his
patients affected by CRMO with non steroidal drugs.
(NSAID’s) This is a very common treatment for CRMO
patients

In the article that I read in Minnesota, I learned
that, CRMO is the most severe form of Chronic
non bacterial Osteomyelitis. It predominantly affects
the metaphyges of the long bone but lesions occur at
any site of the skeleton. Lesions can occur in organs
such as, eyes, tracks and lungs. The article that
information about a 10 year old girl who was
diagnosed. Investigations to prove CRMO are needed,
such as physical examinations and MRI’s. To manage
this disease a patient is put on NSAID’s for three
months, if this does not work usually Sualfasalazine
and Prendizone are used. These are sterodial drugs
used to remove pain. It also contained information
about a girl who was nine years old. She was affected
in her spine. Another test used to investigate was the
sedimentation rate. A usual rate is 10, at one point
mine was 80. This test just measures how high the
energy level is in your body. With this information
you will know if your white blood cells are busy at work if the
energy level is high. Thus hinting that there is an invader
that is being attacked. Or possibly that they are attacking your
bones. Other causes are trauma or recent injury.

Using the Cierney-Madar system Osteomyelitis is
categorized by acute, pain occurs two weeks after
onset. Onset means injury or trauma. Subacute, one to
several weeks after onset. And chronic, few months
after onset. Divided by Waldrogel classification types
are hematogenous, contiguous and chronic. This disease
can be described as “an anti inflammatory disorder”.

This disease was known as a clinical entity for 3
decades before it was recognized as CRMO. It shocked
me to hear from Dr. Quie that, “The probability of
getting CRMO is about one to a million.” Relapses are
frequent even under therapy. This disease may later
become SAPHO (acne) or Arthritis (inflammation of the
joints).

I used to think of this disease as the enemy, but now that
I have learned more about it I have come to think of it as
something that will follow me around throughout my life,
just another thing I must live with. I read somewhere,
“We can’t stop what’s done to us, we can only survive it.”
This quote describes how I feel.