Chronic Recurrent Multifocal Osteomyelitis, also known as Chronic Nonbacterial Osteomyelitis (CNO) is an autoinflammatory disease that mostly affects children. The causes of the disease have been linked to gene mutations in some cases, especially on chromosome 18q in one family. More research is needed on the genetic causes of this challenging condition.
CRMO presents in patients with bone pain and bone lesions that can develop anywhere in the body. This is a rare disease, that has been found to affect more girls than boys. The peak for symptom incidence is around 10 years of age, but symptoms can be present from toddler or preschool age to even when patients are on middle age or older. Some patients can have many affected areas in their body, or only a few sites in their body.
Children will develop deep aching pain, limping, tenderness over affected areas and often fevers. Common sites are the long bones of the body, the collar bone (clavicle) and shoulder girdle. The spine, ankles and feet may also be affected.
Patients may also present with periodic fevers, skin manifestations, such as psoriasis, acne, or pustules on the hands and feet. Some patients may also have uveitis, or inflammatory bowel disease along with CRMO symptoms. Another autoinflammatory disease, Majeed, involves CRMO, but also presents with symptoms of congenital dyserythropoietic anemia and Sweet Syndrome. Majeed is linked to an autosomal recessive inheritance of an LPIN2 gene mutation from both parents, and is a very rare disease.
Here is a helpful video overview about CNO/CRMO by Dr Polly Ferguson, an expert on CNO/CRMO at the 2nd NIH-WRNMMC Symposium on Autoinflammatory and Immunedysregulatory Diseases that the Autoinflammatory Alliance co-sponsored and helped to organize in August 2019:
