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Diagnostic difficulties: chronic recurrent multifocal osteomyelitis and lymphoma. One or two diseases?

Sulko, Jerzy

Journal of Pediatric Orthopaedics B: March 2013 - Volume 22 - Issue 2 - p 170–174
doi: 10.1097/BPB.0b013e328354b481

This paper presents a case report of a 15-year-old boy admitted to the hospital for persistent right knee pain and limping. The clinical appearance of his condition was the basis on which diagnosis of chronic recurrent multifocal osteomyelitis was made. Continuous deterioration in the clinical status also led to a suspicion of the presence of other pathological processes. A bone biopsy was performed and the results of histopathology showed diffused large cell B lymphoma. Chemotherapy was initiated; nevertheless, the patient’s general state worsened gradually and subsequent pancytopenia resulted in septicemia and multiorgan failure that led to the patient’s death. This paper reports the exceptional diagnostic challenges that emerged from the obscure course of the disease.

University Children’s Hospital, Krakow, Poland

Correspondence to Jerzy Sulko, MD, PhD, University Children’s Hospital, ul. Wielicka Street 265, Krakow 33-663, Poland Tel: +48 812 658 2011; fax: +48 126 573 947; e-mail:

© 2013 Lippincott Williams & Wilkins, Inc.