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Bone

Osteomyelitis

Chronic multifocal osteomyelitis

Reviewers: Dariusz Borys, M.D. (see Reviewers page)
Revised: 9 August 2013, last major update June 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● 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
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● Metaphyses of tubular bones, clavicle
● Multiple asymptomatic sites
● Associated skin lesion - pustulosis palmoplantaris

Radiology images
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Chronic type, wrist xray - contributed by Dr. Mark R. Wick

Treatment
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● Non steroidal anti-inflammatory drugs; do not use antibiotics since cultures are negative

Micro description
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● Early neutrophilic inflammation
● Late fibrosis of marrow with chronic inflammatory infiltrate
● Plasma cell predominance
● Fragments of necrotic bone with multinucleated giant cells

Micro images
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Chronic type - contributed by Dr. Mark R. Wick

Differential diagnosis
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● Rheumatic disease
● Bacterial osteomyelitis
● Malignancy

End of Bone > Osteomyelitis > Chronic multifocal osteomyelitis

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