PDF(Pubmed)
Abstract：
Chronic recurrent multifocal osteomyelitis (CRMO) is aseptic and can be diagnosed by excluding other diseases, such as bacterial osteomyelitis, scurvy, metabolic disorders, and malignant diseases; therefore, bone biopsy is usually performed to confirm the diagnosis. To prevent misdiagnosis, the appropriate timing and location for biopsy should be determined from an active phase of inflammation. We presented 3 cases of CRMO involving the mandible: Case 1: A 2-year-old girl diagnosed with CRMO in the chronic phase. A sonogram showed a slightly low echoic area adjacent to the bone cortex. Pathological examination revealed a slight accumulation of leukocytes and plasma cells, as well as predominant fibrous stroma. Case 2: A 9-year-old girl diagnosed with CRMO with massive new osteoid formation. A sonogram showed a massive inhomogeneous low echoic area adjacent to the bone cortex. Pathological examination revealed massive osteoid formation and scattered inflammatory cells infiltration. Case 3: A 3-year-old girl diagnosed with CRMO in the active phase. A sonogram showed a massive hypoechoic area adjacent to the bone cortex and hyperechogenicity associated with a muscular and subcutaneous edema. Pathological examination revealed massive bone destruction and neutrophils infiltration within damaged osteoid. Ultrasound was able to visualize the degree of inflammation in the mandible corresponding to that of the surrounding soft tissue in all 3 cases. Therefore, ultrasound would be useful in determining the appropriate timing and location for bone biopsy.
摘要：
慢性复发性多灶性骨髓炎（CRMO）是无菌的，可以通过排除其他疾病来诊断。比如细菌性骨髓炎,镰刀病,代谢紊乱，和恶性疾病；因此，通常进行骨活检以确认诊断。为了防止误诊，活检的合适时机和位置应从炎症的活动期确定.我们介绍了3例累及下颌骨的CRMO：病例1：一名2岁女孩在慢性期被诊断为CRMO。超声图显示与骨皮质相邻的回声区域略低。病理检查显示白细胞和浆细胞轻微积聚，以及主要的纤维基质。案例2：一名9岁女孩被诊断为CRMO，具有大量新骨形成。超声图显示与骨皮质相邻的大量不均匀的低回声区域。病理检查发现大量骨样形成和分散的炎症细胞浸润。案例3:一名3岁女孩被诊断为处于活跃期的CRMO。超声图显示与骨皮质相邻的大量低回声区域以及与肌肉和皮下水肿相关的高回声性。病理检查显示大量的骨破坏和受损的类骨内的中性粒细胞浸润。在所有3例中，超声都能够显示下颌骨的炎症程度与周围软组织的炎症程度相对应。因此,超声将有助于确定骨活检的适当时机和位置。
