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Chronic Nonbacterial Osteomyelitis

  • Andrea Taddio
  • Serena Pastore
Chapter
Part of the Rare Diseases of the Immune System book series (RDIS)

Abstract

Chronic nonbacterial osteomyelitis (CNO) is a rare inflammatory disorder that primarily affects children. It is characterized by insidious onset of pain, local bone expansion, and radiological findings suggestive of osteomyelitis, usually at multiple sites. CNO predominantly affects metaphyses of long bones, but clavicle and mandible are suggestive of diagnosis. CNO is a diagnosis of exclusion, and its pathogenesis is still unknown. Differential diagnosis includes infections, malignancies, benign bone tumors, metabolic disorders, and other autoinflammatory disorders. Biopsy of the bone lesion is often required. Nonsteroidal anti-inflammatory drugs are the first choice of treatment. Alternative therapies have been used, including corticosteroids, methotrexate, bisphosphonates, and TNFα inhibitors. No guidelines exist on diagnostic and treatment options.

Keywords

Chronic nonbacterial osteomyelitis (CNO) Chronic recurrent multifocal osteomyelitis (CRMO) Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome (SAPHO) Pyogenic arthritis, pyoderma gangrenosum, and acne syndrome (PAPA) Deficiency of IL-1 receptor antagonist (DIRA) Nonsteroidal anti-inflammatory drugs (NSAIDs) Magnetic resonance (MR) Autoinflammatory disease 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Andrea Taddio
    • 1
    • 2
  • Serena Pastore
    • 1
  1. 1.Institute for Maternal and Child Health—IRCCS Burlo GarofoloTriesteItaly
  2. 2.University of TriesteTriesteItaly

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