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Published on: December 31, 2017
Nonbacterial osteitis in children: data of a German Incidence Surveillance Study
Annette F Jansson1, Veit Grote,
1Dr. v. Haunersches Kinderspital, Ludwig-Maximilians University, Munich, Germany. annette.jansson@med.uni-muenchen.de
Insights
Nonbacterial osteitis, an auto-inflammatory disorder, affects approximately 60 German children annually. This study analyzed its incidence, presentation, and diagnosis in pediatric patients, noting frequent spinal involvement and complications.
Area of Science:
- Pediatric Rheumatology
- Auto-inflammatory Disorders
- Pediatric Orthopedics
Background:
- Nonbacterial osteitis (NBO) is a rare inflammatory bone disease in children.
- Understanding its epidemiology and clinical characteristics is crucial for timely diagnosis and management.
Purpose of the Study:
- To determine the incidence of NBO in German pediatric patients.
- To analyze the clinical presentation, laboratory and radiological findings, diagnostic approaches, and therapeutic procedures for NBO.
Main Methods:
- A nationwide incidence survey was conducted in German pediatric and pediatric-orthopaedic hospitals from 2006 to 2008.
- Data on newly diagnosed NBO cases were collected via physician-completed questionnaires.
Main Results:
- 148 pediatric NBO cases were identified, estimating an annual incidence of 0.4 per 100,000 children.
- Mean age at manifestation was 11.4 years, with 67% of patients being female.
- Spinal involvement occurred in 15% of patients, with 9% experiencing vertebral fractures; bone biopsies were performed in 53%.
Conclusions:
- Nonbacterial osteitis is an auto-inflammatory condition leading to at least 60 new pediatric cases yearly in Germany.
- Frequent spinal lesions and complications are observed, even at initial diagnosis, highlighting the need for vigilant assessment.
Aim:
To analyse the incidence, clinical presentation, laboratory and radiological findings, as well as diagnostic approaches and therapeutic procedures in paediatric patients suffering from nonbacterial osteitis.
Methods:
A nationwide incidence survey was conducted from 2006 to 2008 through monthly contacts with all German paediatric and paediatric-orthopaedic hospitals. Children with osteomyelitic bone lesions newly diagnosed as suffering from nonbacterial osteitis were identified. Cases were assessed using a questionnaire to be filled in by the treating physician containing information on time since first symptoms, associated diseases, diagnostic procedures, localization of lesions, complications, laboratory and histological results, and treatment.
Results:
Nonbacterial osteitis was newly reported in 148 children. The annual incidence was estimated at 0.4 per 100,000 children. Mean manifestation age was 11.4 years (SD 3.2); 99 children (67%) were girls. Palmoplantar pustulosis was observed in 8 (6%). Unifocal manifestations were seen in 50 (34%) patients. Of all patients with vertebral involvement (15%), 9% suffered from vertebral fractures. Bone biopsies were taken in 79 (53%) patients.
Conclusions:
Nonbacterial osteitis is an auto-inflammatory disorder resulting in at least 60 new paediatric cases/year in Germany. Spinal lesions and complications are frequently observed, even at first diagnosis.
