An 11-year-old girl presented with a complaint of pain and swelling in her left foot since six months. Magnetic resonant imaging confirmed the diagnosis of chronic multifocal osteomyelitis involving the distal left fibula, lower part of both tibiae, and metatarsal bones of both feet. She reported a history of chronic bloody diarrhea and abdominal pain. She underwent multiple blood transfusions following severe, recurrent hemoglobin drop. The affected lower limb was incised and drained.
Aspirated fluid and tissue biopsy excluded fungal and bacterial causes of chronic osteomyelitis, including mycobacterial tuberculosis. Family history was positive for Crohn’s disease in an aunt. Physical examination revealed fever, pallor, and stunted growth. Blood biochemistry revealed iron deficiency anemia, high erythrocyte sedimentation rate, and C-reactive protein. Colonoscopy showed features of…
