Abdolreza Malek - Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Mohammadhassan Aelami - Department of Pediatrics and Infection Control and Hand Hygiene Research Center, Imam Reza Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Narges Afzali - Department of Radiology, Mashhad branch, Islamic Azad University, Mashhad, Iran
Ali Parsa - Department of Orthopedics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

  Chronic recurrent multifocal osteomyelitis (CRMO) is a rare aseptic, auto-inflammatory bone disorder. CRMO presents with bone pain with or without fever. The diagnosis of CRMO is a diagnosis of exclusion and should be included in the differential diagnosis of chronic inflammatory bone lesions in children. Cultures of the bone are typically sterile, antibiotic therapy does not result in clinical improvement whereas anti-inflammatory drugs improve the condition. Furthermore, biopsy should be considered in chronic and relapsing bone pain and swelling unresponsive to treatment. Herein, we present a nine-year-old boy complaining of recurrent pain in his upper and lower extremities. On examination he had mild fever and cervical lymphadenopathy. He also had experienced bone pain and weight loss in the recent month. Based on biopsy and bone scan he was finally diagnosed with CRMO. Naproxen and Pamidronate was prescribed and he was getting better and returned to normal life and activity without need to corticosteroids.

Bone pain, Children, Chronic multifocal osteomyelitis (CRMO)