Chronic recurrent multifocal osteomyelitis
A case of chronic recurrent osteomyelitis (CRMO) in a girl aged ten years is presented. This is an unusual inflammatory process which involves multiple osseous sites recurrently. The symptoms are insidious pain in the limbs associated with fever and, occasionally, pustulosis palmoplantaris. The disease is characterized by recurrent exacerbations but is self-limiting. Complete investigation including bone biopsy should be carried out for differential diagnostic reasons but repeated invasive investigations and repeated antibiotic treatment should be avoided on recognition of the disease. No consistent laboratory findings, apart from raised erythrocyte sedimentation rate, are found.