OBSOLETE: Juvenile chronic recurrent multifocal osteomyelitis

Juvenile chronic recurrent multifocal osteomyelitis (JCRMO), now more commonly referred to as chronic recurrent multifocal osteomyelitis (CRMO) or chronic nonbacterial osteomyelitis (CNO), is an autoinflammatory bone disorder that primarily affects children and adolescents. This Orphanet entry (ORPHA:2778) is considered obsolete, as the condition has been reclassified under the broader entity of chronic recurrent multifocal osteomyelitis (CRMO). The disease is characterized by recurrent episodes of sterile (non-infectious) bone inflammation occurring at multiple skeletal sites simultaneously or sequentially. It predominantly affects the metaphyses of long bones, the clavicle, vertebral bodies, and the pelvis. Patients typically present with bone pain, localized swelling, and tenderness at affected sites. Fever and malaise may accompany flares. The condition can be associated with skin manifestations such as palmoplantar pustulosis, psoriasis, and acne, as well as inflammatory bowel disease in some cases. Radiographic findings include osteolytic lesions that may mimic infectious osteomyelitis or malignancy, often requiring biopsy to exclude these diagnoses. The course is characterized by periods of relapse and remission. Treatment typically involves nonsteroidal anti-inflammatory drugs (NSAIDs) as first-line therapy, with bisphosphonates, corticosteroids, and biologic agents such as TNF-alpha inhibitors reserved for refractory cases. The prognosis is generally favorable, though some patients may experience prolonged disease courses with skeletal complications including growth disturbances, vertebral compression fractures, or chronic pain. As this entry is obsolete, patients and clinicians should refer to the current classification under CRMO/CNO for the most up-to-date information.

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