Multifocal Non-Suppurative Osteomyelitis
Multifocal Non-Suppurative Osteomyelitis and Caffey’s Disease are associated with various syndrome in a group called SAPHO (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis)
| Sub-acute recurrent multiple osteomyelitis | Sterno-Costo-clavicular hyperostosis |
|---|---|
| Children/Adolescence | Age of 40s/50s |
| Recurrent attack of pain, swelling, tenderness (long bone metaphysics; femur, tibia, medial clavicle, vertebrae) | Confined to the sternum and adjacent bones and vertebrae |
| Association with the cutaneous lesion (pustulosis seen) | Same |
| Slight fever and ESR may be elevated | Same |
| Small lytic changes in metaphysics adjacent to physis surrounded by sclerosis | Hyperostosis of medial end of clavicle, sternum, ribs and ossification of costoclavicular ligaments |
| Spine: Collapse | Ossification of anterior longitudinal ligament, end plate erosion, sclerosis of individual vertebrae, the collapse of vertebrae |
| Radioscintgraphy: Increase Uptake | Same |
| Treatment is palliative | Same |
Infantile Cortical Hyperostosis (Caffey’s disease)
It is a rare disease in infants and young children which usually starts in 1st few months of life with painful swelling over tubular bones and/ or mandible
The child is feverish, irritable, refusing to move the affected limb
Infection may be suspected but apart from swelling no local signs of inflammation
Radiological Investigation
Periosteal new bone formation resulting in a thickness of the affected bone
ESR: Elevated
Cause: Unknown (Viral infection is suspected)
Treatment: Antibiotics are employed sometimes (but doubtful)
Other causes of osteomyelitis like hyperostosis (Osteomyelitis, scurvy) should be ruled out.
See also: Acute Hematogenous Osteomyelitis
See also: Subacute hematogenous osteomyelitis
See also: Chronic Osteomyelitis
See also: Garre’s Sclerosing Osteomyelitis
