From: Chronic recurrent multifocal osteomyelitis: a case report
Diagnostic criteria of CRMO proposed by Jansson et al. | Diagnostic criteria proposed by Roderick et al. | |
Major criteria: 1 Radiologically proven osteolytic/−sclerotic bone lesion 2 Multifocal bone lesions 3 PPP or psoriasis 4. Sterile bone biopsy with signs of inflammation and/or fibrosis, sclerosis | Minor criteria: 1 Normal blood count and good general state of health 2 CRP and ESR mildly-to-moderately elevated 3 Observation time longer than 6 months 4 Hyperostosis 5 Associated with other autoimmune diseases apart from PPP or psoriasis 6 Grade I or II relatives with autoimmune or autoinflammatory disease, or with CRMO | 1 The presence of typical clinical findings: Bone pain +/−localized swelling without significant local or systemic features of inflammation or infection + 2 The presence of typical radiological findings: X-ray showing combination of lytic areas, sclerosis and new bone formation, or STIR MRI showing bone marrow oedema +/− bone expansion, lytic areas and periosteal reaction Associated with 1 More than one bone (or clavicle alone) without significantly raised CRP (CRP < 30 g/L) or 2 Unifocal disease (other than clavicle), or CRP > 30 g/L, with bone biopsy showing inflammatory changes (plasma cells, osteoclasts, fibrosis or sclerosis) with no bacterial growth whilst not on antibiotic therapy |
CRMO is confirmed by two major criteria or one major and three minor criteria | ||
Diagnostic score proposed by Jansson et al. | ||
Normal blood cell count | 13 | Score from 0 to 28 probably not CRMO; score from 29 to 38 uncertain diagnosis, and score values of 39 probably CRMO. |
Symmetric lesions | 10 | |
Lesions with marginal sclerosis | 10 | |
Normal body temperature | 9 | |
Vertebral, clavicular, sternal lesions | 8 | |
Radiologically proven lesions | 7 | |
CRP 1 mg/dl | 6 | |
Total clinical score | 63 |