EURORAD ESR

Case 14212

Chronic Recurrent Multifocal Osteomyelitis (CRMO) of the clavicle

Author(s)
Julie Desimpel1, 2, Filip M. Vanhoenacker1, 2, 3
1. Department of radiology, Antwerp University Hospital, Edegem, Belgium
2. Department of radiology, General Hospital Sint-Maarten, Duffel-Mechelen, Belgium
3. Department of radiology, Gent University Hospital, Belgium

University Hospital Antwerp, Department of Radiology, University Hospital Antwerp; Wilrijkstraat, 10 2650 Antwerp, Belgium; Email:filip.vanhoenacker@telenet.be
 
Patient
female, 11 year(s)
 
 
  • Figure 1
    Clinical image

    Clinical image of the patient with a marked swelling of the medial side of the clavicle (white arrow)

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Conventional radiography; Procedure: Localisation; Special Focus: Inflammation;
     
     
  • Figure 2
    Standard radiography

    Standard radiograph shows an expansion of the bone at the medial side of the right clavicle. There is osteosclerosis of the bone with a solid periosteal reaction (arrow).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 3
    Computed Tomography

    Computed tomography(coronal reformatted image). Inhomogeneous and sclerotic aspect with a solid periosteal reaction.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 4
    Coronal T1-weighted MRI Image

    Coronal MRI image. The lesion is hypo-intense compared to bone marrow on T1-weighted images.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 5
    Coronal T2 - weighted MRI image

    Coronal MRI image. The lesion remains relatively hypointense compared to fluid within the sternoclavicular joint on fatsuppressed T2-weighted images. Note osseous expansion of the lesion beyond the original cortex of...

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 6
    Coronal Fatsuppressed T1-weighted image after intravenous administration of gadoliniumcontrast

    Note slightly heterogeneously contrast enhancement within the affected part of the clavicle, which is most prominent adjacent to the sternoclavicular joint. Note also subtle enhancement of the soft tissues adjacent to...

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 7
    Standard radiography femur

    Standard radiography shows inhomogeneous sclerosis of the distal metaphysis and diaphysis of the right femur (predominantly of the dorsal portion) (arrow).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
  • Figure 8
    Standard radiography tibia

    Standard radiography shows inhomogeneous sclerosis of the distal metaphysis and diaphysis of the right tibia (predominantly of the anterior portion) (arrow).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
Clinical image of the patient with a marked swelling of the medial side of the clavicle (white arrow)
 
Standard radiograph shows an expansion of the bone at the medial side of the right clavicle. There is osteosclerosis of the bone with a solid periosteal reaction (arrow).
 
Computed tomography(coronal reformatted image). Inhomogeneous and sclerotic aspect with a solid periosteal reaction.
 
Coronal MRI image. The lesion is hypo-intense compared to bone marrow on T1-weighted images.
 
Coronal MRI image. The lesion remains relatively hypointense compared to fluid within the sternoclavicular joint on fatsuppressed T2-weighted images. Note osseous expansion of the lesion beyond the original cortex of the clavicle (black arrow).
 
Note slightly heterogeneously contrast enhancement within the affected part of the clavicle, which is most prominent adjacent to the sternoclavicular joint. Note also subtle enhancement of the soft tissues adjacent to clavicle (arrow).
 
Standard radiography shows inhomogeneous sclerosis of the distal metaphysis and diaphysis of the right femur (predominantly of the dorsal portion) (arrow).
 
Standard radiography shows inhomogeneous sclerosis of the distal metaphysis and diaphysis of the right tibia (predominantly of the anterior portion) (arrow).
 
 
 
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