Case ReportChronic nonbacterial osteomyelitis involving the mandible: A case report

- Chronic recurrent multifocal osteomyelitis (CMRO), or chronic nonbacterial osteomyelitis (CNO), is a very rare condition of unknown aetiology. It is characterised by focal sterile inflammatory disease with prolonged, self-limiting and recurrent episodes.
- Relatively few cases of CMRO have been reported since the first description in 1972 by Giedion, and is poorly characterised in the maxillofacial surgery literature due to the use of inconsistent terminology.
- CMRO is a very rare disease characterised by recurrent flare-ups of inflammatory bone pain related to aseptic osteomyelitis; lesions can be unifocal (CNO) or multifocal (CMRO).
- The proper course of treatment for CMRO remains unclear and no standard therapy is available.

IntroductionChronic nonbacterial osteomyelitis (CNO) or chronic recurrent multifocal osteomyelitis (CRMO), is a very rare condition of unknown aetiology. It is characterised by focal sterile inflammatory disease with prolonged, self-limiting and recurrent episodes.Case presentationWe report the discovery of this very rare disease following a mandibular abscess in a 10-year-old female. We initially focus on the difference between the preoperative orthopantomography and the maxillofacial computed tomography and magnetic resonance images obtained, and then on the improvement of strategies for correct diagnosis and treatment of this disease.DiscussionBone pain and localised swelling can occur in a single bone or can spread to soft tissue and adjacent bone; areas commonly affected by CMRO include the metaphyseal plates of the long bones, as well as the spine, clavicle and, rarely, the maxillofacial area. The clinical presentation of CMRO includes pain, functional impairment, and swelling, similar to our case.ConclusionsWe report a very rare case of this unifocal mandibular disease in a child who presented for an abscess and was then diagnosed and treated for CNO.