Eight-Year Scintigraphic Follow-up of a Patient with Chronic Recurrent Multifocal Osteomyelitis (CRMO): A Case Report

Articles in Press

Document Type : Case report

Author

Department of Nuclear Medicine, Vali-asr Hospital, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

10.22038/aojnmb.2025.89201.1646

Abstract

Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a rare autoinflammatory bone disorder characterized by episodic bone pain, swelling, and radiologic evidence of sterile osteolytic lesions. We report the case of a 55-year-old woman with breast cancer as well as a long-standing history of rheumatoid arthritis who presented with chronic pain and radiologic findings of bilateral, metaphyseal-diaphyseal tibial lesions evolving over an eight-year period. The bone lesions appeared spontaneously, remained for variable durations, and regressed without specific treatment, paralleling pain severity. Laboratory data showed elevated inflammatory markers, while biopsy ruled out infection and malignancy. Bone scintigraphy and MRI confirmed multifocal active bone lesions, consistent with CRMO. The case highlights the diagnostic challenges of CRMO in adults, especially in the presence of other autoimmune conditions, and emphasizes the importance of long-term imaging follow-up. This case also illustrates that CRMO may mimic malignancy or infectious osteomyelitis, yet respond well to anti-inflammatory therapy alone. Early recognition can prevent unnecessary interventions.

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Asia Oceania Journal of Nuclear Medicine and Biology

Articles in Press, Accepted Manuscript
Available Online from 08 November 2025

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