Conjunctival involvement in chronic recurrent multifocal osteomyelitis

PURPOSE: To report a case of chronic recurrent multifocal osteomyelitis (CRMO) with conjunctival involvement. METHODS: Retrospective chart review. RESULTS: A 10-year-old girl who complained of fatigue and debilitating pain in both hips and legs for >1 year had recurrent episodes of redness and discharge in both eyes with little response to different topical medications. The diagnosis of CRMO was confirmed with the help of magnetic resonance imaging, bone scan, and bone biopsy results. She had moderate hyperemia and multiple discrete salmon-colored lesions in both palpebral and fornical conjunctivae. Biopsy revealed chronic inflammatory infiltration composed predominantly of lymphocytes forming a follicular pattern. Conjunctival lesions worsened during relapses of skeletal symptoms, improved during remission, and resolved shortly after the initiation of oral prednisolone therapy. No recurrence was observed during 16 months of follow-up. CONCLUSIONS: Salmon-colored conjunctival lesions may accompany CRMO and respond favorably to systemic steroid therapy.