Evolution of chronic recurrent multifocal osteitis toward spondylarthropathy over the long term
Corresponding Author
Olivier Vittecoq
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Service de Rhumatologie, Centre Hospitalier Universitaire de Rouen, 76031 Rouen Cedex, FranceSearch for more papers by this authorLamia Ait Said
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorChantal Michot
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorOthmane Mejjad
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorJean-Michel Thomine
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorPaul Mitrofanoff
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorJoël Lechevallier
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorPatrick Ledosseur
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorAlain Gayet
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorPhilippe Lauret
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorXavier Le Loët
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorCorresponding Author
Olivier Vittecoq
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Service de Rhumatologie, Centre Hospitalier Universitaire de Rouen, 76031 Rouen Cedex, FranceSearch for more papers by this authorLamia Ait Said
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorChantal Michot
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorOthmane Mejjad
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorJean-Michel Thomine
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorPaul Mitrofanoff
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorJoël Lechevallier
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorPatrick Ledosseur
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorAlain Gayet
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorPhilippe Lauret
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorXavier Le Loët
Centre Hospitalier Universitaire de Rouen, INSERM U519, and the Collège des Rhumatologues de Haute Normandie, Rouen, France
Search for more papers by this authorAbstract
Objective
To retrospectively assess, with a sufficiently long followup (mean 11.6 years; median 9 years), the long-term outcome of chronic recurrent multifocal osteitis (CRMO), a multifocal, inflammatory bone disease.
Methods
Patients included were 8 children/adolescents and 7 adults with no family history of rheumatic disease who had been diagnosed as having CRMO between 1979 and 1995. Ten patients had undergone at least 1 bone biopsy of the lesions, with histologic examination and multiple cultures. In 1996, in addition to an in-depth interview, 12 patients underwent an extensive physical examination, laboratory evaluation, HLA–A, B, C, and DR typing, bone radiography and scintigraphy, and computed tomography scan of the sternoclavicular and sacroiliac joints.
Results
Remission was observed in 3 patients. The other 12 patients developed various associations of vertebral (n = 10), sacroiliac (n = 6), anterior thoracic (n = 7), peripheral articular (n = 2), enthesopathic (n = 4), or dermatologic (palmoplantar pustulosis in 3 cases and psoriasis in 2) involvements. Spine involvement was the most common and occurred the earliest (median time to appearance after the onset of osteitis 5.63 years). Clinical sacroiliitis was always unilateral. No patients carried the HLA–B27 haplotype. CRMO responded well to nonsteroidal antiinflammatory drugs. Twelve patients met the European Spondylarthropathy Study Group criteria for spondylarthopathy.
Conclusion
After 10 years, CRMO had usually evolved to spondylarthropathy, but with certain features not usually seen in the latter: predominantly, unilateral sacroiliitis, no familial form, and no link with HLA–B27.
REFERENCES
- 1 Giedion A, Holthusen W, Masel LF, Vischer D. Subacute and chronic symmetrical osteomyelitis. Ann Radiol 1972; 15: 329–42.
- 2 Gustavson KH, Wilbrand HF. Chronic symmetric osteomyelitis. Acta Radiol 1974; 15: 551–7.
- 3 Probst FP. Chronic multifocal cleido-metaphyseal osteomyelitis in children. Acta Radiol 1976; 17: 531–7.
- 4 Bjorksten B, Gustavson KH, Eriksson B, Lindholm A, Nordstrom S. Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris. J Pediatr 1978; 93: 227–31.
- 5 Probst FP, Bjorksten B, Gustavson KH. Radiological aspects of chronic recurrent multifocal osteomyelitis. Ann Radiol 1978; 21: 115–25.
- 6 Bjorksten B, Boquist L. Histological aspects of chronic recurrent multifocal osteomyelitis. Br J Bone Joint Surg 1980; 62: 376–80.
- 7 Sonozaki H, Kawashima M, Hongo O, Yaoita H, Ikeno M, Matsuura M, et al. Incidence of arthro-osteitis in patients with pustulosis palmaris and plantaris. Ann Rheum Dis 1981; 40: 554–7.
- 8 Le Loët X, Bonnet B, Thomine E, Mejjad O, Lucet L, Louvel JP, et al. Manifestations ostéoarticulaires de la pustulose palmo-plantaire: etude prospective de 15 cas. Presse Med 1991; 20: 1307–11.
- 9 Szanto E, Linse U. Arthropathy associated with palmoplantar pustulosis. Clin Rheumatol 1991; 10: 130–5.
- 10 Laxer RM, Shore AD, Manson D, King S, Silverman ED, Wilmot DM, et al. Chronic recurrent multifocal osteomyelitis and psoriasis: a report of a new association and review of related disorders. Semin Arthritis Rheum 1988; 17: 260–70.
- 11 Rosner IA, Richter DE, Huettner TL, Kuffner GH, Wisnieski JJ, Burg CG. Spondylarthropathy associated with hidradenitis suppuration and acne conglobata. Ann Intern Med 1982; 97: 520–5.
- 12 Majeed HA, Kalaawi M, Mohanty D, Teebi AS, Tunjekar MF, al-Gharbawy F, et al. Congenital dyserythropoietic anemia and chronic recurrent multifocal osteomyelitis in three related children and the association with Sweet syndrome in two siblings. J Pediatr 1989; 115: 730–4.
- 13 Sonozaki H, Azuma A, Okai K, Nakamura K, Fukuoka S, Tateishi A, et al. Clinical features of 22 cases with “inter-sterno-costo-clavicular ossifications”: a new rheumatic syndrome. Arch Orthop Trauma Surg 1979; 95: 13–22.
- 14 Kohler B, Uehlineer E, Kutzner J, West TB. Sterno-Kosto-Klavikulare Hyperostose, ein bischer nitch beschribenes krankheitshild. Dtsch Med Wochenschr 1975; 100: 1519–23.
- 15 Chamot AM, Benhamou CL, Kahn MF, Beraneck L, Kaplan G, Prost A. Le syndrome acne pustulose hyperostose ostéite (SAPHO): résultat d'une enquête nationale. Rev Rhum Mal Osteoartic 1987; 54: 187–96.
- 16 Huaux JP, Esselinckx W, Rombouts JJ, Maldague B, Malghem J, Devogelaer JP, et al. Pustulotic arthroosteitis and chronic recurrent multifocal osteomyelitis in children: report of three cases. J Rheumatol 1988; 15: 95–100.
- 17 Lucet L, Le Loët X, Ménard JF, Mejjad O, Louvel JP, Janvresse A, et al. Computed tomography of the normal sternoclavicular joint. Skeletal Radiol 1996; 25: 237–41.
- 18 Thorel JB, Cavelier B, Bonneau JC, Simonin JL, Ropartz C, Deshayes P. Study of a population carrying HLA B27 antigen compared with a population without B27, in the detection of ankylosing spondylitis. Rev Rhum Mal Osteoartic 1978; 45: 275–82.
- 19 Dougados M, van der Linden S, Juhlin R, Huitfeldt B, Amor B, Calin A, et al, and the European Spondylarthropathy Study Group. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum 1991; 34: 1218–30.
- 20 Edlund E, Johnsson U, Lidgren L, Pettersson H, Sturfelt G, Swensson B, et al. Palmoplantar pustulosis and sternoclavicular arthro-osteitis. Ann Rheum Dis 1988; 47: 809–15.
- 21 Jurik AG, Moller SH, Mosekild L. Chronic sclerosing osteomyelitis of the iliac bone: etiological possibilities. Skeletal Radiol 1988; 17: 114–8.
- 22 Van Howe RS, Stanshak RJ, Chusid MJ. Chronic recurrent multifocal osteomyelitis. Clin Pediatr 1989; 28: 54–9.
- 23 Cyrlak D, Pais MJ. Chronic recurrent multifocal osteomyelitis. Skeletal Radiol 1988; 15: 32–9.
- 24 Cailleux N, Le Loët X, Lamour A, Michot C, Thomine JM, Deshayes P. Ostéite aseptique pseudo-sarcomateuse de la clavicule. Rev Rhum Mal Osteoartic 1990; 57: 905–6.
- 25 Beraneck L, Kaplan G, Girardet JP. Ostéite chronique récurrente multifocale: evolution sur 12 ans; rapport avec le SAPHO. Rev Rhum Mal Osteoartic 1990; 57: 473–5.
- 26 King SM, Laxer RM, Manson D, Gold R. Chronic recurrent multifocal osteomyelitis: a non infectious inflammatory process. Pediatr Infect Dis J 1987; 6: 907–11.
- 27 Murray SD, Kehl DK. Chronic recurrent multifocal osteomyelitis: a case report. Am J Bone Joint Surg 1984; 66: 1110–2.
- 28 Prose NS, Fahrner IJ, Miller CR, Layfield L. Pustular psoriasis with chronic recurrent multifocal osteomyelitis and spontaneous fractures. J Am Acad Dermatol 1994; 31: 376–9.
- 29 Fournié A, Bouvier M, Fournié B, Colson F, Ayrolles C, Larbre JP. Hyperostose-ostéite-périostite: triade radiologique des enthésopathies. Remarques à propos de 2 localisations fémorales inhabituelles. Rev Rhum Mal Osteoartic 1989; 56: 763–6.
- 30 Jurik AG, Helmig O, Ternowitz T, Moller BN. Chronic recurrent multifocal osteomyelitis: a follow up study. J Pediatr Orthop 1988; 8: 49–58.
- 31 Trotta F, La Corte R, Bajocchi G, Manicardi S. Hyperostosis and multifocal osteitis: a purely rheumatological subset of the SAPHO syndrome. Clin Exp Rheumatol 1990; 8: 401–5.
- 32 Ralston SH, Scott PDR, Sturrock RD. An unusual case of pustulotic arthro-osteitis affecting the leg and erosive polyarthritis. Ann Rheum Dis 1990; 49: 643–5.
- 33 Beraneck L, Kaplan G, Benoist M, Bouchon JP, Prost A, Vassal JP, et al. Hyperostose multiple avec sacroiléite unilatérale: une nouvelle spondylarthropathie. Presse Med 1984; 13: 2001–4.
- 34 Maugars Y, Berthelot JM, Ducloux JM, Prost A. SAPHO syndrome: a follow-up study of 19 cases with special emphasis on enthesis involvement. J Rheumatol 1995; 22: 2135–41.
- 35 Doucet E, Le Loët X, Thomine E, Fléchet ML, Lauret P, Deshayes P. Les manifestations ostéoarticulaires de la pustulose palmoplantaire. Presse Med 1987; 16: 1957–60.
- 36 Hunter LY, Hensinger RN. Destructive arthritis associated with acne fulminans: a case report. Ann Rheum Dis 1980; 39: 403–5.
- 37 Watts RA, Crisp AJ, Hazleman BL, Daunt SO, Jenner JR. Arthro-osteitis: a clinical spectrum. Br J Rheumatol 1993; 32: 403–7.
- 38 McGee TC, Field RS, Loebl DH, Bailey JP, Sizemore KR. Pustulotic arthro-osteitis: a cause of typical chest pain and a new arthritic syndrome. South Med J 1993; 86: 469–72.
- 39 Toussirot E, Dupond JL, Wendling D. Spondylodiscitis in SAPHO syndrome: a series of eight cases. Ann Rheum Dis 1997; 56: 52–8.
- 40 Mejjad O, Daragon A, Louvel JP, da Silva LF, Thomine E, Lauret P, et al. Osteoarticular manifestations of pustulosis palmaris et plantaris and of psoriasis: two distinct entities. Ann Rheum Dis 1996; 55: 177–80.
- 41 Arnett FC, Hochberg FC, Bias WB. Cross-reactive HLA antigens in B27 negative Reiter's syndrome and sacroiliitis. Johns Hopkins Med J 1977; 141: 193–7.
- 42 Cedoz JP, Wendling D, Viel JF. The B7 cross-reactive group and spondylarthropathies: an epidemiological approach. J Rheumatol 1995; 22: 1884–90.
- 43 Sonozaki H, Mitsui H, Miyanaga Y, Okitsu K, Igarashi M, Hayashi Y, et al. Clinical features of 53 cases with pustulotic arthro-osteitis. Ann Rheum Dis 1981; 40: 547–53.
- 44 Saghafi M, Henderson MJ, Buchanan NW. Sternocostoclavicular hyperostosis. Semin Arthritis Rheum 1993; 22: 215–23.
- 45 Kurc D, De Saint-Père R, Madoule P, Laoussadi S, Caquet R. Les ostéites et arthrites chroniques de la pustulose palmo-plantaire. Rev Med Interne 1987; 8: 79–84.
- 46 Gaucher A, Pèré P, Regent D, Grandhaye P, Aussedat R, Vivard T. Spondylarthropathies ou polyenthésites ossifiantes. Rev Rhum Mal Osteoartic 1987; 54: 243–8.
- 47 Fournié B. Le territoire enthésique et le syndrome d'hyperostose-ostéite-périostite: une approche nosologique radioclinique des spondylarthropathies inflammatoires. Rev Rhum 1993; 60: 485–8.
- 48 François RJ. Le rachis dans la spondylarthrite ankylosante. Brussels: Editions ARSCIA; 1976.
