National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Chronic recurrent multifocal osteomyelitis



Other Names:
CRMO; Multifocal osteomyelitis, chronic; Chronic multifocal osteomyelitis; CRMO; Multifocal osteomyelitis, chronic; Chronic multifocal osteomyelitis; CMO; Chronic nonbacterial osteomyelitis/Chronic recurrent multifocal osteomyelitis; CNO/CRMO See More
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Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone condition. Signs and symtpoms include recurrent episodes of pain and joint swelling, with or without fever. Symptoms typically begin in childhood. CRMO may occur alone, with psoriasis or inflammatory bowel disease, or as part of the syndromes, Majeed syndrome or DIRA. For most children, CRMO resolves after many years without lasting effects. However, CRMO can cause slow growth and permanent bone deformity.[1][2]
Last updated: 5/15/2013

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
80%-99% of people have these symptoms
Bone pain 0002653
Hyperostosis
Bone overgrowth
0100774
Osteomyelitis
Bone infection
0002754
30%-79% of people have these symptoms
Abnormal vertebral morphology 0003468
Abnormality of epiphysis morphology
Abnormal shape of end part of bone
0005930
Abnormality of the metaphysis
Abnormality of the wide portion of a long bone
0000944
Arthritis
Joint inflammation
0001369
Craniofacial osteosclerosis 0005464
Edema
Fluid retention
Water retention
[ more ]
0000969
Elevated C-reactive protein level 0011227
Elevated erythrocyte sedimentation rate
High ESR
0003565
Fatigue
Tired
Tiredness
[ more ]
0012378
Osteolysis
Breakdown of bone
0002797
Poor appetite
Decreased appetite
0004396
Weight loss 0001824
5%-29% of people have these symptoms
Abnormality of the sacroiliac joint 0100781
Acne 0001061
Anemia
Low number of red blood cells or hemoglobin
0001903
Cranial nerve paralysis 0006824
Fever 0001945
Inflammation of the large intestine 0002037
Palmoplantar pustulosis 0100847
Pruritus
Itching
Itchy skin
Skin itching
[ more ]
0000989
Psoriasiform dermatitis 0003765
Scoliosis 0002650
Skin rash 0000988
Vasculitis
Inflammation of blood vessel
0002633
Percent of people who have these symptoms is not available through HPO
Autosomal recessive inheritance 0000007
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Last updated: 7/1/2020

Due to the rare nature of the condition, there is limited data regarding the best treatment approach for people with chronic recurrent multifocal osteomyelitis (CRMO). When CRMO occurs along with  psoriasis or inflammatory bowel disease the goal is to treat both the CRMO as well as the skin and gastrointestinal symptoms. In this situation, treatment with a TNF inhibitor may be recommended. Initial treatment of isolated CRMO often involves NSAIDs. If NSAIDs are unable to control pain, additional treatment options include antirheumatic drugs (e.g., corticosteroids, methotrexate, sulfasalazine, colchicine, and azithromycin), TNF inhibitors, or bisphosphonates.[1]
Last updated: 5/15/2013

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources


Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Differential diagnosis includes mainly acute or subacute bacterial osteomyelitis, juvenile idiopathic arthritis, hypophosphatasia, Langerhans cell histiocytosis, and malignancies like osteosarcoma, Ewing sarcoma, neuroblastoma, rhabdomyosarcoma, leukemia, and lymphoma. Rare monogenetic syndromes with CNO/CRMO as a component must also be excluded, such as Majeed syndrome, PAPA syndrome and DIRA syndrome (sterile multifocal osteomyelitis with periostitis and pustulosis).
Visit the Orphanet disease page for more information.

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • Orphanet lists European clinical trials, research studies, and patient registries enrolling people with this condition. 

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Organizations Providing General Support


These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

In-Depth Information

  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Chronic recurrent multifocal osteomyelitis. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

  • My son was diagnosed 2 years ago. At first he was doing good on his pain medication, but now he needs medicine before he can even get up as he can't move. Is there anything else that can treat his pain? See answer



  1. Ferguson PJ, Sandu M. Current understanding of the pathogenesis and management of chronic recurrent multifocal osteomyelitis. Curr Rheumatol Rep. 2012 Apr;14(2):130-41; http://www.ncbi.nlm.nih.gov/pubmed/?term=22359228. Accessed 5/15/2013.
  2. Majeed syndrome. Genetics Home Reference. August 2009; http://www.ghr.nlm.nih.gov/condition/majeed-syndrome. Accessed 5/15/2013.