Chronic osteomyelitislike disease with negative bacterial cultures
P. Pelkonen, S. Ryoppy, J. Jaaskelainen, J. Rapola, H. Repo and I. Kaitila
Children's Hospital, Helsinki, Finland.
During a seven-year period we observed 14 children who had chronic
osteomyelitislike disease. The bacterial cultures from the bone lesions
were negative. In eight patients the findings were compatible with chronic
recurrent multifocal osteomyelitis (CRMO), in four the findings were
compatible with chronic sclerosing osteomyelitis of Garre, and two had
osteomyelitis of the clavicle. In patients with CRMO, lymphocyte
subpopulations, the responses to mitogens, and the chemotactic and
chemokinetic responses showed no consistent abnormalities. After a mean
follow-up of 4.5 years (range, one to ten years), all four patients with
osteomyelitis of Garre were symptomatic, and two had complications. Only
two of the eight patients with CRMO had active disease. The course had been
complicated by growth disturbances in one patient and by thoracic outlet
syndrome in another. Wegener's granulomatosis later developed in a patient
with CRMO.
