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Chronic Osteomyelitislike Disease With Negative Bacterial Cultures

Chronic Osteomyelitislike Disease With Negative Bacterial Cultures Abstract • During a seven-year period we observed 14 children who had chronic osteomyelitislike disease. The bacterial cultures from the bone lesions were negative. In eight patients the findings were compatible with chronic recurrent multifocal osteomyelitis (CRMO), in four the findings were compatible with chronic sclerosing osteomyelitis of Garré, and two had osteomyelitis of the clavicle. In patients with CRMO, lymphocyte subpopulations, the responses to mitogens, and the chemotactic and chemokinetic responses showed no consistent abnormalities. After a mean followup of 4.5 years (range, one to ten years), all four patients with osteomyelitis of Garré were symptomatic, and two had complications. Only two of the eight patients with CRMO had active disease. The course had been complicated by growth disturbances in one patient and by thoracic outlet syndrome in another. Wegener's granulomatosis later developed in a patient with CRMO. (AJDC 1988;142:1167-1173) References 1. Garré C: Ueber besondere Formen und Folgezustände der akuten infektiösen Osteomyelitis . Beitr Klin Chirurgie 1893;10:241-298. 2. Wishner J: Chronic sclerosing osteomyelitis (Garrè) . J Bone Joint Surg 1933;15:723-732. 3. Collert S, Isacson J: Chronic sclerosing osteomyelitis (Garrè) . Clin Orthop 1982;164: 136-140. 4. Harris NH, Kirkaldy-Willis WH: Primary subacute osteomyelitis . J Bone Joint Surg 1965; 47B:526-532. 5. Jani L, Remagen W: Primary chronic osteomyelitis . Int Orthop 1983;7:79-83.Crossref 6. Gledhill RB: Subacute osteomyelitis in children . Clin Orthop 1973;96:57-69. 7. Giedion A, Holthusen W, Masel LF, et al: Subacute and chronic 'symmetrical' osteomyelitis . Ann Radiol 1972;15:330-342. 8. Gustavson KH, Wilbrand HF: Chronic symmetric osteomyelitis: Report of a case . Acta Radiol 1974;15:551-557. 9. Probst FP, Björkstén B, Gustavson KH: Radiological aspects of chronic recurrent multifocal osteomyelitis . Ann Radiol 1978;21:115-125. 10. Björkstén B, Gustavson KH, Eriksson B, et al: Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris . J Pediatr 1978; 93:227-231.Crossref 11. Girardet J-P, Sambucy F, Douillet P, et al: Ostéomyélite symétrique subaiguë . Arch Fr Pediatr 1979;36:418-422. 12. Björkstén B, Boquist L: Histopathological aspects of chronic recurrent multifocal osteomyelitis . J Bone Joint Surg 1980;62B:376-380. 13. Solheim LF, Paus B, Liverud K, et al: Chronic recurrent multifocal osteomyelitis: A new clinical-radiological syndrome . Acta Orthop Scand 1980;51:37-41.Crossref 14. Meller Y, Yagupsky P, Elitsur Y, et al: Chronic multifocal symmetrical osteomyelitis: Report of two cases in bedouin infants . AJDC 1984;138:349-351. 15. Paller AS, Pachman L, Rich K, et al: Pustulosis palmaris et plantaris: Its association with chronic recurrent multifocal osteomyelitis . J Am Acad Dermatol 1985;12:927-930.Crossref 16. Fujita K, Iseki K-I, Azuma H, et al: Subacute symmetrical osteomyelitis . AJDC 1985; 139:750-751. 17. Gamble JG, Rinsky LA: Chronic recurrent multifocal osteomyelitis: A distinct clinical entity . J Pediatr Orthop 1986;6:579-584.Crossref 18. Repo H, Kostiala AAI, Kosunen TU: Use of leucocyte migration under agarose to study spontaneous and directed locomotion of leucocytes . Immunology 1978;35:539-548. 19. Appell RG, Oppermann HC, Becker W, et al: Condensing osteitis of the clavicle in childhood: A rare sclerotic bone lesion: Review of the literature and report of seven patients . Pediatr Radiol 1983;13:301-306.Crossref 20. Speer DP: Chronic multifocal symmetric osteomyelitis . AJDC 1984;138:340. 21. Kunnamo I, Kallio P, Pelkonen P, et al: Clinical signs and laboratory tests in the differential diagnosis of arthritis in children . AJDC 1987;141:34-40. 22. Putto A, Ruuskanen O, Meurman O, et al: C-reactive protein in the evaluation of febrile illness . Arch Dis Child 1986;61:24-29.Crossref 23. Hedström SÅ: Immunoassay of acute phase reactants and latex-CRP as activity tests in chronic staphylococcal osteomyelitis . Scand J Infect Dis 1983;15:161-165. 24. Clark RA, Page RC, Wilde G: Defective neutrophil chemotaxis in juvenile periodontitis . Infect Immun 1977;18:694-700. 25. Maderazo E, Woronick CL, Ward PA: Leukokinesis-enhancing factor in human serum: Partial characterization and relationship to disorders of leukocyte migration . Clin Immunol Immunopathol 1979;12:382-395.Crossref 26. Jacobs JC, Goetzl EJ: 'Streaking leukocyte factor,' arthritis, and pyoderma gangrenosum . Pediatrics 1975;56:570-578. 27. Blockey NJ: Chronic osteomyelitis: An unusual variant . J Bone Joint Surg 1983;65B:120-123. 28. Fauci AS, Haynes BF, Katz P, et al: Wegener's granulomatosis: Prospective clinical and therapeutic experience with 85 patients for 21 years . Ann Intern Med 1983;98:76-85.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Chronic Osteomyelitislike Disease With Negative Bacterial Cultures

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References (34)

Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1988.02150110045017
Publisher site
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Abstract

Abstract • During a seven-year period we observed 14 children who had chronic osteomyelitislike disease. The bacterial cultures from the bone lesions were negative. In eight patients the findings were compatible with chronic recurrent multifocal osteomyelitis (CRMO), in four the findings were compatible with chronic sclerosing osteomyelitis of Garré, and two had osteomyelitis of the clavicle. In patients with CRMO, lymphocyte subpopulations, the responses to mitogens, and the chemotactic and chemokinetic responses showed no consistent abnormalities. After a mean followup of 4.5 years (range, one to ten years), all four patients with osteomyelitis of Garré were symptomatic, and two had complications. Only two of the eight patients with CRMO had active disease. The course had been complicated by growth disturbances in one patient and by thoracic outlet syndrome in another. Wegener's granulomatosis later developed in a patient with CRMO. (AJDC 1988;142:1167-1173) References 1. Garré C: Ueber besondere Formen und Folgezustände der akuten infektiösen Osteomyelitis . Beitr Klin Chirurgie 1893;10:241-298. 2. Wishner J: Chronic sclerosing osteomyelitis (Garrè) . J Bone Joint Surg 1933;15:723-732. 3. Collert S, Isacson J: Chronic sclerosing osteomyelitis (Garrè) . Clin Orthop 1982;164: 136-140. 4. Harris NH, Kirkaldy-Willis WH: Primary subacute osteomyelitis . J Bone Joint Surg 1965; 47B:526-532. 5. Jani L, Remagen W: Primary chronic osteomyelitis . Int Orthop 1983;7:79-83.Crossref 6. Gledhill RB: Subacute osteomyelitis in children . Clin Orthop 1973;96:57-69. 7. Giedion A, Holthusen W, Masel LF, et al: Subacute and chronic 'symmetrical' osteomyelitis . Ann Radiol 1972;15:330-342. 8. Gustavson KH, Wilbrand HF: Chronic symmetric osteomyelitis: Report of a case . Acta Radiol 1974;15:551-557. 9. Probst FP, Björkstén B, Gustavson KH: Radiological aspects of chronic recurrent multifocal osteomyelitis . Ann Radiol 1978;21:115-125. 10. Björkstén B, Gustavson KH, Eriksson B, et al: Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris . J Pediatr 1978; 93:227-231.Crossref 11. Girardet J-P, Sambucy F, Douillet P, et al: Ostéomyélite symétrique subaiguë . Arch Fr Pediatr 1979;36:418-422. 12. Björkstén B, Boquist L: Histopathological aspects of chronic recurrent multifocal osteomyelitis . J Bone Joint Surg 1980;62B:376-380. 13. Solheim LF, Paus B, Liverud K, et al: Chronic recurrent multifocal osteomyelitis: A new clinical-radiological syndrome . Acta Orthop Scand 1980;51:37-41.Crossref 14. Meller Y, Yagupsky P, Elitsur Y, et al: Chronic multifocal symmetrical osteomyelitis: Report of two cases in bedouin infants . AJDC 1984;138:349-351. 15. Paller AS, Pachman L, Rich K, et al: Pustulosis palmaris et plantaris: Its association with chronic recurrent multifocal osteomyelitis . J Am Acad Dermatol 1985;12:927-930.Crossref 16. Fujita K, Iseki K-I, Azuma H, et al: Subacute symmetrical osteomyelitis . AJDC 1985; 139:750-751. 17. Gamble JG, Rinsky LA: Chronic recurrent multifocal osteomyelitis: A distinct clinical entity . J Pediatr Orthop 1986;6:579-584.Crossref 18. Repo H, Kostiala AAI, Kosunen TU: Use of leucocyte migration under agarose to study spontaneous and directed locomotion of leucocytes . Immunology 1978;35:539-548. 19. Appell RG, Oppermann HC, Becker W, et al: Condensing osteitis of the clavicle in childhood: A rare sclerotic bone lesion: Review of the literature and report of seven patients . Pediatr Radiol 1983;13:301-306.Crossref 20. Speer DP: Chronic multifocal symmetric osteomyelitis . AJDC 1984;138:340. 21. Kunnamo I, Kallio P, Pelkonen P, et al: Clinical signs and laboratory tests in the differential diagnosis of arthritis in children . AJDC 1987;141:34-40. 22. Putto A, Ruuskanen O, Meurman O, et al: C-reactive protein in the evaluation of febrile illness . Arch Dis Child 1986;61:24-29.Crossref 23. Hedström SÅ: Immunoassay of acute phase reactants and latex-CRP as activity tests in chronic staphylococcal osteomyelitis . Scand J Infect Dis 1983;15:161-165. 24. Clark RA, Page RC, Wilde G: Defective neutrophil chemotaxis in juvenile periodontitis . Infect Immun 1977;18:694-700. 25. Maderazo E, Woronick CL, Ward PA: Leukokinesis-enhancing factor in human serum: Partial characterization and relationship to disorders of leukocyte migration . Clin Immunol Immunopathol 1979;12:382-395.Crossref 26. Jacobs JC, Goetzl EJ: 'Streaking leukocyte factor,' arthritis, and pyoderma gangrenosum . Pediatrics 1975;56:570-578. 27. Blockey NJ: Chronic osteomyelitis: An unusual variant . J Bone Joint Surg 1983;65B:120-123. 28. Fauci AS, Haynes BF, Katz P, et al: Wegener's granulomatosis: Prospective clinical and therapeutic experience with 85 patients for 21 years . Ann Intern Med 1983;98:76-85.Crossref

Journal

American Journal of Diseases of Children – American Medical Association

Published: Nov 1, 1988

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