Spinal Involvement in Patients with Chronic Non-Bacterial Osteomyelitis (CNO): An Analysis of Distinctive Imaging...

Area of Science:

• Radiology
• Orthopedics
• Rheumatology

Background:

• Chronic non-bacterial osteomyelitis (CNO) of the spine presents diagnostic challenges.
• Differential diagnosis often includes bacterial spondylodiscitis and spinal neoplasia.

Purpose of the Study:

• To identify imaging characteristics of spinal CNO.
• To differentiate CNO from other spinal diseases using imaging features.

Main Methods:

• Retrospective analysis of imaging studies from 45 patients with CNO.
• Assessment by two radiologists across five referral centers.
• Evaluation of spinal lesions in both pediatric and adult populations.

Main Results:

• Spinal lesions observed in 17 patients, predominantly in the thoracic spine.
• Pediatric CNO showed short-segment vertebral body destruction.
• Adult CNO featured bone marrow edema, osteosclerosis, endplate irregularities, and ankylosing lesions.
• Posterior element involvement (costovertebral and facet joints) was a key differentiator.

Conclusions:

• Specific imaging findings aid in differentiating spinal CNO from neoplasia and other inflammatory conditions.
• Detailed imaging review can potentially decrease the necessity for invasive biopsies in CNO diagnosis.