Osteomielite crônica multifocal recorrente: estado da arte
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Resumo
A osteomielite crônica multifocal recorrente é uma doença autoinflamatória que se caracteriza por focos estéreis de inflamação óssea que produzem dor recorrente. É uma entidade pouco frequente que tem como manifestações cardinais a presença de lesões ósseas inflamatórias nas regiões metaepifisárias dos ossos longos que predomina em membros inferiores. Esta doença, com frequência associada com sintomas sistémicos e lesões na pele, faz parte do grupo de doenças que conforma o síndrome: artritedermatite. As descobertas radiológicos mais comuns são as áreas de osteólise rodeadas de um rasto esclerótico delgado, sem reação periosteal associada ou a formação de sequestros ósseos. A ressonância nuclear magnética permite fazer uma detecção precoce da entidade e facilita seu diagnóstico diferencial, principalmente, com infecções e tumores ósseos. O tratamento está baseado na informação obtida mediante reportes de caso e séries de pacientes e consiste no uso de antinflamatórios não esteróides e em casos refratários, bisfosfonatos e antagonistas do fator de necrose tumoral alfa. O prognóstico desta doença, em geral, é bom, com um curso clínico benigno e autolimitado, na maioria dos casos.
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Referências
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