What is CRMO?
CRMO is an autoinflammatory condition in which inflammation develops within the bones without an identifiable infection. The inflammation can cause bone pain, tenderness and sometimes swelling. The exact cause is unknown, but it is thought to involve an abnormal regulation of the immune system. CRMO is not caused by bacteria, and is not contagious.
Signs to look out for
- Pain in a bone, which may fluctuate or persist over time
- Localised tenderness or swelling over an affected bone
- Pain that is worse at night or interrupts sleep
- Reduced movement or difficulty participating in usual activities
Symptoms vary depending on which bones are affected. Common sites include the long bones of the legs, the pelvis, the collarbone and the spine. Different bones may become inflamed at different times, and some areas of inflammation may cause few or no symptoms.
How CRMO is diagnosed
Many other conditions may mimic CRMO. There is no single test that confirms CRMO, and investigations are often aimed at excluding alternative causes of bone pain and inflammation. Investigations often include blood tests, MRI, and at times a bone biopsy.
How CRMO is managed
The aim of treatment is to control inflammation, relieve pain, protect bone health and help your child return to their usual activities. Treatment depends on the sites of bone inflammation and how the condition responds over time. It may include:
- Anti-inflammatory medicines (NSAIDs), often used as initial treatment
- Bisphosphonates, particularly when inflammation affects the spine or when NSAIDs have been inadequate in controlling inflammation
- Biologic medicines, occasionally required for more persistent or severe disease that has not responded to the above measures
Common questions
Will my child grow out of CRMO?
CRMO can become inactive over time, particularly as children approach adulthood. Some children experience periods of inflammation followed by long periods of remission, while others have more persistent disease requiring ongoing treatment.
Can my child still play sport?
In many cases, yes. Physical activity is encouraged where appropriate, but recommendations depend on the location and severity of bone inflammation. Activities may need to be modified during periods of active pain, particularly if the spine or a weight-bearing bone is affected.
Is CRMO an infection?
No. CRMO is a non-bacterial inflammatory condition, rather than a bone infection. Antibiotics do not treat CRMO, although infection must be considered and excluded when making the diagnosis.
Will my child need ongoing appointments or MRI scans?
Follow-up depends on disease activity, treatment and the bones involved. Some children need periodic MRI scans to monitor inflammation, particularly when symptoms do not reliably reflect disease activity or when important sites such as the spine are affected.
Do we need a referral?
Yes. A referral from your GP or specialist is needed for a Medicare rebate. Please address this to Dr Jessica McGrath at Arc Specialist Care.
Seeing us in Brisbane
Ask your GP or specialist for a referral to Dr Jessica McGrath at Arc Specialist Care, then call us to book.
This page is general information only and is not a substitute for advice about your child's individual situation. Please speak with your doctor about your child's care.