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Characteristics and outcomes of chronic non-bacterial osteitis in children
Stefanie Wintrich1, Gerd Horneff1
1Department of Paediatrics, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany.
Insights
Chronic non-bacterial osteitis (CNO) in children is increasingly diagnosed with MRI. Non-steroidal anti-inflammatory drugs (NSAIDs) are effective treatments, leading to good clinical outcomes for all patients.
Area of Science:
- Pediatric rheumatology
- Pediatric orthopedics
- Pediatric bone diseases
Background:
- Chronic non-bacterial osteitis (CNO) is a rare inflammatory bone disorder affecting children.
- Accurate diagnosis and effective treatment are crucial for managing CNO and preventing long-term complications.
Purpose of the Study:
- To characterize patient demographics, clinical presentation, and disease patterns in pediatric CNO.
- To evaluate treatment strategies and clinical outcomes for children diagnosed with CNO.
Main Methods:
- Retrospective analysis of 32 pediatric patients diagnosed with CNO between 2006 and 2013.
- Data collected included patient characteristics, clinical findings, imaging results (MRI, radiography, scintigraphy), and treatment responses.
Main Results:
- The pelvis and clavicle were most frequently affected; foot skeleton involvement was common (60%).
- Magnetic resonance imaging (MRI) identified pathological findings in all examined patients.
- Non-steroidal anti-inflammatory drugs (NSAIDs) were the primary treatment, achieving remission or satisfactory outcomes in all cases.
Conclusions:
- CNO diagnosis increasingly relies on MRI, with histology being less common.
- NSAIDs are highly effective for treating pediatric CNO.
- All patients in this cohort experienced good clinical outcomes, highlighting the efficacy of current management strategies.
Objective:
To determine patient characteristics, clinical presentation, pattern of involvement, treatment, and outcome of patients with chronic non-bacterial osteitis (CNO).
Material And Methods:
Consecutive cases of CNO were analyzed at a single center for pediatrics and adolescent medicine from 2006 to 2013 in terms of patient characteristics, clinical presentation, pattern of involvement, treatment, and outcome.
Results:
We identified 32 children aged 1.5-15 years who were diagnosed with CNO between 2006 and 2013. A maximum of 12 bones per patient were affected in a total of 114 documented locations. The pelvis and clavicle (affecting 34% of patients each) were the most frequently affected bones. The foot skeleton was the most commonly affected region in 60% of patients. Skin manifestations were found in 7 (21%) patient. Increased inflammatory signs at presentation were detected in 18 patients. Pathological findings were found in all 30 children examined using magnetic resonance imaging (MRI), in 10 of 11 children examined using radiography, and in 8 of 10 patients examined using skeletal scintigraphy. Bone biopsy was performed in 9 patients. For initial treatment, non-steroidal anti-inflammatory drugs (NSAIDs) or coxibs were used in 28 (87.5%) patients. Remission or satisfactory follow-up was achieved in all patients.
Conclusion:
Today, CNO is increasingly diagnosed using MRI and rarely through histological examinations. Therapeutic strategies include NSAIDs, which are often highly effective. All patients in the present study showed good clinical outcomes.
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