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Chronic non-bacterial osteomyelitis: a comparative study between children and adults
Andrea Skrabl-Baumgartner1, Peter Singer2, Theresa Greimel2
1Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria. andrea.skrabl-baumgartner@medunigraz.at.
Pediatric Rheumatology Online Journal
|July 25, 2019
Summary
Chronic non-bacterial osteomyelitis (CNO) and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome may be a single condition. While presentation differs, a unified diagnostic and treatment strategy is suggested for pediatric and adult patients.
Area of Science:
- Rheumatology
- Pediatric Rheumatology
- Osteology
Background:
- Chronic non-bacterial osteomyelitis (CNO) and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome are inflammatory bone disorders.
- Distinguishing between pediatric and adult presentations is crucial for effective management.
Purpose of the Study:
- To compare clinical presentation, diagnostic and treatment strategies, and outcomes in pediatric versus adult patients with CNO/CRMO and SAPHO syndrome.
- To evaluate the potential for a unified clinical syndrome across age groups.
Main Methods:
- Retrospective single-centre comparative study.
- Inclusion of pediatric patients with chronic recurrent multifocal osteomyelitis (CRMO)/CNO and adult patients with SAPHO syndrome.
- Comparison of clinical, diagnostic, and treatment data.
Main Results:
- Similarities in initial presentation, laboratory, and histopathological findings between pediatric and adult groups.
- Differences in skeletal site involvement (sternal vs. clavicle/long bones) and imaging modalities used (CT vs. MRI).
- More frequent bisphosphonate use and better outcomes observed in pediatric patients.
Conclusions:
- CNO/CRMO and SAPHO syndrome in children and adults may represent a single clinical entity.
- A similar diagnostic and therapeutic approach may be warranted for both pediatric and adult patients.
- Further research into a unified management strategy is suggested.
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