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Table 1 Diagnostic criteria and diagnostic score for CRMO (modified by references n° 8, 16, 26)

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