Hello OCAD colleagues
Man 25 years old, have chronic pain laterally in the right leg since childhood. It gets worse at night, chronic intermittent and recurrent pain, patient cannot sleep at night when pain comes, he gets some pain relive with paracetamol. Patient have denies fever or systemic illness. Denies any trauma. Normal laboratory, otherwise healthy. He moved to Norway in 2015 due to war in Afghanistan. In 2015, he was diagnosed with "chronic stress reaction”. They never investigated the lesion thoroughly. In 2024, he still has the lesion in his fibula, which has grown. Still intermittent pain.On images, we see an elongated lytic lesion intramedullary in the distal metaphysis of the fibula with high signal centrally in water-sensitive series and chronic thickening-sclerosis or cortical hyperostosis, We can see small vessels around the canal. No fistula, sequestra or soft tissue component. No cortical discontinuity.
Could this be chronic CMO/CRMO?? Another idea?
Best regards
Samia
