Diagnostic Challenge and Clinical Management of Juvenile Mandibular Chronic Osteomyelitis

• Published in: Head & neck pathology (Totowa, N.J.) Vol. 14; no. 3; pp. 842 - 846
• Main Authors: Zimmermann, Caroline, Stuepp, Rúbia Teodoro, Rath, Inês Beatriz da Silva, Grando, Liliane Janete, Daniel, Filipe Ivan, Meurer, Maria Inês
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-09-2020
• Subjects: Anti-Bacterial Agents - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Case Reports; Child; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - drug therapy; Dentistry; Diagnostic Errors; Female; Humans; Indomethacin - therapeutic use; Mandibular Diseases - diagnosis; Mandibular Diseases - drug therapy; Medicine; Medicine & Public Health; Mumps - diagnosis; Mumps - drug therapy; Oral and Maxillofacial Surgery; Osteomyelitis - diagnosis; Osteomyelitis - drug therapy; Otorhinolaryngology; Parotitis - diagnosis; Parotitis - drug therapy; Pathology; Diagnostic imaging; Mandibular diseases; Diagnosis; Child
• ISSN: 1936-0568; 1936-055X; 1936-0568
• DOI: 10.1007/s12105-019-01087-1

Juvenile mandibular chronic osteomyelitis (JMCO) is a rare, idiopathic disease of chronic bone inflammation without suppuration, sinus tract formation, or sequestration. As the name suggests, this condition predominately affects children. The few cases of JMCO reported in the literature describe different treatments, and thus a standard therapy protocol has not yet been established. The aim of this paper is to report a clinical case in a 9-year-old girl that was misdiagnosed and unsuccessfully treated for 1 year. After experiencing persistent symptoms, a correct diagnosis was subsequently rendered based on the physical and radiographic examination as well as successful treatment with non-steroidal anti-inflammatory drugs (NSAIDs). The patient received drug therapy followed by periods of remission over a 4 year follow-up period. Diagnosis and treatment of JMCO is a challenge given the rarity and nonspecific signs and symptoms of this condition. Treatment with NSAIDs and regular follow-up is a conservative option for these patients.