Retinal vasculitis with Chronic Recurrent Multifocal Osteomyelitis: A case report and review of the literature

Document Type

Journal Article

Publication Date

1-1-2019

Journal

BMC Rheumatology

Volume

3

Issue

1

DOI

10.1186/s41927-019-0076-5

Keywords

Case report; Chronic recurrent multifocal osteomyelitis; CRMO; Retinal Vasculitis; SAPHO; Sternoclavicular

Abstract

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Background: Concurrent presentation of retinal vasculitis with mixed sclerotic and lytic bone lesions is rare. Case presentation: We present the case of a 37-year old woman with a several year history of episodic sternoclavicular pain who presented for rheumatologic evaluation due to a recent diagnosis of retinal vasculitis. We review the differential diagnosis of retinal vasculitis, along with the differential diagnosis of mixed sclerotic and lytic bone lesions. Ultimately, bone marrow biopsy confirmed diagnosis of chronic recurrent multifocal osteomyelitis (CRMO) . Concurrent presentation of CRMO with retinal vasculitis is extremely rare but important to recognize. The patient demonstrated clinical response to prednisone and tumor necrosis factor-alpha inhibition (TNF-i). Conclusion: This case reports and unusual presentation of CRMO spectrum disease involving the sternum and sternoclavicular joint with concurrent retinal vasculitis.

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