Bone
Osteomyelitis
Chronic multifocal osteomyelitis



Topic Completed: 1 June 2012

Revised: 27 December 2018

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Chronic multifocal osteomyelitis
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Cite this page: Borys D Chronic multifocal osteomyelitis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonechronicmultifocal.html. Accessed February 15th, 2019.
Definition / general
  • Recurrent variant of osteomyelitis in children and young adults of unknown origin (Hum Pathol 1999;30:59)
  • Low grade fever, local swelling and pain
  • Periods of exacerbation and remission over years
  • Negative cultures
Sites
  • Metaphyses of tubular bones, clavicle
  • Multiple asymptomatic sites
  • Associated skin lesion - pustulosis palmoplantaris
Radiology images

Contributed by Dr. Mark R. Wick
Missing Image

Chronic type, wrist xray

Treatment
  • Non steroidal anti-inflammatory drugs; do not use antibiotics since cultures are negative
Microscopic (histologic) description
  • Early neutrophilic inflammation
  • Late fibrosis of marrow with chronic inflammatory infiltrate
  • Plasma cell predominance
  • Fragments of necrotic bone with multinucleated giant cells
Microscopic (histologic) images

Contributed by Dr. Mark R. Wick
Missing Image

Chronic type

Differential diagnosis
  • Rheumatic disease
  • Bacterial osteomyelitis
  • Malignancy