Diagnosis of CRMO
This disease is difficult to diagnose, and it will often need a team of doctors, composed of a pediatrician, an orthopedic surgeon, a radiologist and a pathologist to make a complete evaluation. Diagnosis is often by exclusion of other bone diseases that it mimics, because initial history, physical examination and laboratory work-ups show non-specific results pointing to an inflammatory process.
Blood studies show signs of inflammation, such as increased erythrocyte sedimentation rate and C-reactive protein level with a normal white blood cell count.
Bone biopsy reveals inflammatory changes without signs of bacterial infection.
Radiological evaluation usually presents multifocal bone involvement. Inflammation and osteolytic lesions or evidences of bone destruction are observed, but these are similar to other diseases and not characteristic of CRMO alone. Although the tibia (leg bone) is the most commonly involved site, many other bones are most likely to be found positive for changes like the hip bones, shoulder and collar bones, and even the mandible and ribs. X-rays, bone scans, CT scans and MRI are useful in evaluating bone changes and progression of the disease.