Sir.—The report by Meller and colleagues1 of chronic multifocal symmetrical osteomyelitis reminds us of one of our patients with subacute symmetrical osteomyelitis.2 The radiologic findings were so intense that neoplastic disorders had to be differentiated.3 We would like to add this Japanese case to the review of patients having this controversial disease.
Patient Report.—A 29-month-old Japanese boy was admitted to our hospital because of pain, marked swelling of his left knee, and fever. Six months before admission, he had refused abruptly to stand because of leg pain accompanied by low-grade fever and slight swelling of his left knee. He took conservative treatment in a few private outpatient clinics for ten days. Because his symptoms continued he was admitted to the hospital. He was treated under the diagnosis of juvenile rheumatoid arthritis for 16 days and was discharged in improved condition. He had no fever but