Skater Puts Rare Condition on Ice: CRMO


MICHIGAN (Ivanhoe Newswire) – If your child is in pain and you’re chalking it up to growing pains, think again. It may be because of a rare condition.

Figure skating is hard enough. Launching into the air, rotating twice, and landing on a one sixteenth-inch piece of steel is even harder. Now, imagine doing it with a condition that causes lesions on your bones.

Twelve-year-old Jett VanSchoten has a condition called chronic recurrent multifocal osteomyelitis – or CRMO – an auto inflammatory disorder mostly in kids.

“Well, like, the spots that had lesions in them, like, I would feel throbbing pain,” Jett recalls.

There’s no known cause or cure. Jett’s own immune system attacks normal, healthy bones.

Pediatric rheumatologist at Michigan Medicine, Nadine Saad, MD explains, “In some children, it’s very mild, and in others, it’s very severe and debilitating, and it prevents them from going to school or participating in sports.”

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Jett’s symptoms began three years ago, when a lump appeared under her knee. Treatments for CRMO range from anti-inflammatories to immuno-suppressants.

“Once they’re started on treatment, we usually follow up with MRIs, about every three to six months, to make sure that the lesions are getting better, or if they’re changing,” Dr. Saad ass.

Jett is on a combination of meds that allow her to continue skating and says kids with CRMO should also pursue their passions.

“Like, you should probably do a sport, if you have it because it’s, like, I guess, really good for you, and it gets your mind off of it,” Jett says.

CRMO is most common in girls, beginning at about age nine or 10, and most commonly affects the long bones in the patient’s legs and arms.

Contributors to this news report include: Hillary Rubin, Producer; Mike Naddeo, Videographer; Roque Correa, Editor.

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Nadine Saad, MD, Pediatric Rheumatologist, Michigan Medicine




REPORT:        MB #5380

BACKGROUND: CRMO or Chronic Recurrent Multifocal Osteomyelitis, also known as chronic nonbacterial osteomyelitis (CNO), is a rare condition that triggers bone inflammation. It is an autoimmune disorder, which means it’s caused by the immune system mistakenly attacking healthy tissue and organs, leading to inflammation. Children with CRMO usually experience pain and swelling of the affected bones, followed by periods of remission (no symptoms). It typically affects the long bones and can also affect the pelvis or the spine. Sometimes, it is diagnosed along with inflammatory bowel disease or psoriasis. CRMO typically affects children around the age of nine or 10 and is more common in girls than boys. It can affect one bone or multiple bones and cause bone deformities or slow growth in children. The peak is 10 years of age and CRMO appears more commonly up to 67–85% in females rather than boys.


DIAGNOSING: CRMO can affect one or more bones. It most commonly affects the long bones in a child’s legs. It also occurs in a child’s pelvis and spine more commonly than in other bones. But keep in mind that CRMO can flare up anywhere. CRMO symptoms include pain the most common one, joint inflammation, bone deformities, slowed growth, fatigue and increased risk fracture. The symptoms can come and go while your child is growing up. Once your child’s doctor has found an appropriate treatment, the condition will likely go into a period of remission. This is when the inflammation and other symptoms are gone. But symptoms can return at any time even once your child has gone into remission. They’re more likely to return after the treatment stops.


TREATMENT: The treatment for this depends on their severity and the bones that are affected. Typically, non-steroidal anti-inflammatory drugs (NSAIDs) are used as the first line of treatment. However, some patients may require additional medications such as methotrexate, biologics (etanercept, adalimumab, infliximab, anakinra), and bisphosphonates (pamidronate, zoledronic acid). Methotrexate and biologic medications may increase the risk of infection, so patients should be evaluated by their rheumatology provider if they experience a fever or any symptoms of infection. It is mandatory to undergo tuberculosis (TB) screening before beginning biologic medications.



Valerie Goodwin                                 Kara Gavin      

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