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Chronic Non-bacterial Osteomyelitis (CNO) In Childhood: A Review

Fiona Price-Kuehne1, Kate Armon1

  • 1Department of Paediatrics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Current Pediatric Reviews
|October 28, 2022
PubMed

Insights

Chronic non-bacterial osteomyelitis (CNO) is a common childhood bone disease that is often missed. Early diagnosis and management are crucial to prevent long-term complications.

Area of Science:

  • Pediatric Rheumatology
  • Autoinflammatory Diseases
  • Bone Metabolism

Background:

  • Chronic non-bacterial osteomyelitis (CNO) is an autoinflammatory bone disorder primarily affecting children and adolescents.
  • Despite being the most common childhood autoinflammatory bone disease, CNO is frequently underdiagnosed due to low awareness and lack of diagnostic criteria.
  • The unknown pathogenesis and absence of randomized controlled trials complicate targeted treatment strategies.

Purpose of the Study:

  • To review current understanding of CNO pathophysiology.
  • To outline clinical features for differential diagnosis.
  • To provide an approach for investigating and managing pediatric CNO.

Main Methods:

  • Literature review of current concepts in CNO.
  • Summary of clinical presentations and diagnostic challenges.
  • Discussion of current management strategies based on retrospective data.

Main Results:

  • CNO is likely underdiagnosed and underreported in pediatric populations.
  • Differentiating CNO from mimics requires careful clinical evaluation.
  • Management relies on expert consensus and case series due to limited evidence.

Conclusions:

  • Timely and thorough investigation is essential for accurate CNO diagnosis in children.
  • Excluding mimics and initiating appropriate management can prevent disease complications.
  • Further research, including randomized controlled trials, is needed to improve CNO understanding and treatment.

Keywords:
Autoinflammatory bone disorderchronic nonbacterial osteomyelitischronic recurrent multifocal osteomyelitisclinical featurescurrent concepts in pathophysiologyinvestigation and management.

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