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The True Definition of a Warrior

We are all aware of osteomyelitis but what about CRMO - Chronic Recurrent Multifocal Osteomyelitis...

From the moment I saw the movie Star Wars as a child, I became a life-long fan of warriors. Watching these specimens of super-human strength overcome incredible odds against the toughest of enemies gave me hours of endless joy. In fact, many of my childhood scrapes and bruises came from my attempts to wield a light saber and use the force against the invisible enemies that lived in my closet.

In my eyes, a warrior was someone with no fear, no doubt and who always knew exactly what to do in every situation. Fast forward a few years…. If you follow Zoe’s Story, you know that…

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 Patients With Bone Infections May Benefit As Much From Oral Antibiotics As IVs, OVIVA Study Finds

It’s not often I am struck by what appears to be a game-changing study. The OVIVA study should be practice changing for patients with bone infections. This Oral Versus Intravenous Antibiotics for Bone and Joint Infection trial just found that oral antibiotics are as efficacious as IV (intravenous) antibiotics, so should greatly improve the quality of life for patients, as well as reducing hospitalization costs. OVIVA is better than earlier studies as it was randomized and more representative of clinical practice.

Articles of Interest

Osteomyelitis: Making the Diagnosis

In summary, osteomyelitis is a difficult diagnosis to make. Certainly there are specific tests – i.e. probing to bone, findings on x-ray in the right clinical setting – but no test is sensitive enough to rule out. Inflammatory markers can again aid in raising suspicion, but are insensitive to rule out. Keep a high index of suspicion, and either admit for MRI, or secure good follow-up for patients with diabetic foot ulcers that present acutely or subacutely.

She Had Pain in Her Knee but No Obvious Injury. Why?

C.R.M.O. is an autoinflammatory disease — and a rare one. While there have most likely been fewer than 1,000 cases reported worldwide, Imundo suspects it is frequently overlooked and underdiagnosed. In her own practice, she is currently caring for nine patients with the disorder. In this poorly understood disease, the body suddenly responds as if there is an infection, even though none is present. Patients often have fever and pain. C.R.M.O. usually occurs during times of intense growth and is most common in girls ages 7 to 12. Although painful and sometimes destructive to the bone, C.R.M.O. usually resolves on its own after a few years.

Chronic osteomyelitis: what the surgeon needs to know

Osteomyelitis is an ancient disease, which has been present for the last 250 million years and was first described in humans by Hippocrates.

Chronic recurrent multifocal osteomyelitis (CRMO) – advancing the diagnosis

Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic nonbacterial osteomyelitis (CNO), is an inflammatory bone disease occurring primarily in children and adolescents unfamiliar to many. It was first described in 1972 by Giedion as “an unusual form of multifocal bone lesions with subacute and chronic symmetrical osteomyelitis”

How plagues help scientists puzzle out the past

Osteomyelitis is a very broad category of pathology; the term is used to describe any infection of the bone itself. It is the one sign accessible to bioarchaeologists who work on bone of potential smallpox infections.

Management of Acute Osteomyelitis: A Ten-Year Experience

Osteomyelitis is an infection of the bone; proper management requires prolonged antibiotic treatment. Controversy exists as to when a patient should transition from intravenous to oral antibiotics. However, due to the high bioavailability of some oral antibiotics, optimal time to transition from high to low bioavailability antibiotics is a more valid consideration.

Physicians' Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis

Chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis (CRMO), is an autoinflammatory bone disease of unknown cause that can result in persistent bone pain, bone destruction, functional disability, and pathological fractures.

Strategies to make a definitive diagnosis of osteomyelitis

If you’re not sure what to do next, you’re not alone. Diagnosing and managing osteomyelitis, particularly in elderly diabetic patients, can be difficult. Practice guidelines released last fall by the Infectious Diseases Society of America (IDSA), for example, note that osteomyelitis is the most “difficult and controversial aspect in the management of diabetic foot infections.”

The imaging of osteomyelitis

There is a particular emphasis on magnetic resonance imaging (MRI), which is the best available imaging modality owing to its high sensitivity for detecting early osteomyelitis, excellent anatomical detail and superior soft tissue resolution.

Resources

CRMO Awareness

CRMO (Chronic Recurrent Multifocal Osteomyelitis) is an auto-inflammatory disorder. It comprises of periodic bone pain, fever and appearance of multiple bone lesions. It affects 1 in a million, mostly found in children My name is Sally Hope and I was diagnosed with CRMO when I was 8 years old.

Kaila’s Komfort

Kaila’s Komfort is a 501(c)(3) non-profit organization that was created to provide comfort to children and adults diagnosed with Chr​onic Recurrent Multifocal Osteomyelitis (CRMO), to bring awareness, and to support families affected by this disease. We ship care packages around the world to kids and adults with CRMO and their families.

Zoe’s Story

Zoe’s Story is a non-profit 501c3 organization. We are a charitable organization and provide children with a journaling kit to help them express and communicate their feelings and emotions as they battle this illness.

GARD

Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone condition. Signs and symtpoms include recurrent episodes of pain and joint swelling, with or without fever. Symptoms typically begin in childhood.

StatPearls

Healthy intact bone is resistant to infection. The bone becomes susceptible to disease with the introduction of a large inoculum of bacteria, from trauma, ischemia, or the presence of foreign bodies because bone sites to which microorganisms can bind are exposed. Certain bacteria such as Staphylococcus aureus adhere to the bone by expressing receptors, called adhesins, for some components of the bone matrix, including laminin, collagen, fibronectin, and bone sialoglycoprotein.