April 11, 2024

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 osteomyelitisSterno-Costo-clavicular hyperostosis
Children/AdolescenceAge 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 sclerosisHyperostosis of medial end of clavicle, sternum, ribs and ossification of costoclavicular ligaments
Spine: CollapseOssification of anterior longitudinal ligament, end plate erosion, sclerosis of individual vertebrae, the collapse of vertebrae
Radioscintgraphy: Increase UptakeSame
Treatment is palliativeSame
Multifocal Non-Suppurative Osteomyelitis
Multifocal Non-suppurative Osteomyelitis and Caffey's Disease

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