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Idiopathic nasal bone osteitis: A preliminary report on a recently recognized entity
Yotam Shkedy1, Ohad Ronen, Sarah Gips
1Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, 39 Jabotinski St., Petah Tikva, Israel 4941492. yotam80@gmail.com.
Idiopathic nasal bone osteitis (NBO) is a rare condition. Technetium-99m-methylene-diphosphonate (Tc-MDP) bone scans can help diagnose NBO, with specific ratios indicating the disease, and antibiotic treatment is effective.
Area of Science:
- Otorhinolaryngology
- Nuclear Medicine
- Radiology
Background:
- Osteitis of the nasal bones (NBO) is uncommon and typically has a known cause.
- Idiopathic NBO, without a clear etiology, has not been previously described in medical literature.
Purpose of the Study:
- To analyze the clinical behavior and outcomes of idiopathic NBO.
- To establish diagnostic criteria for idiopathic NBO using technetium-99m-methylene-diphosphonate (Tc-MDP) bone scanning.
Main Methods:
- A retrospective, controlled study involving 9 women with idiopathic NBO and 20 control subjects.
- Utilized clinical evaluation, computed tomography (CT), and Tc-MDP bone scanning.
- Calculated lesion-to-nonlesion ratios (L/R ratios) from bone scans for diagnostic analysis.
Main Results:
- All Tc-MDP bone scans in the idiopathic NBO group were indicative of osteitis.
- Intravenous antibiotic therapy proved effective in all patients.
- Established cutoff L/R ratios of 2.05 for planar views and 2.34 for single-photon emission computed tomography (SPECT) views for diagnosis.
Conclusions:
- Idiopathic NBO can be diagnosed and effectively treated with antibiotics.
- Tc-MDP bone scanning, with specific L/R ratio cutoffs, is a valuable tool for diagnosing idiopathic NBO.
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