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Chronic non-bacterial osteomyelitis: a comparative study between children and adults.

Abstract

BACKGROUND

To compare clinical presentation, diagnostic and treatment strategies, and outcome between pediatric and adult patients with chronic non-bacterial osteomyelitis (CNO).

METHODS

Retrospective single-centre comparative study of pediatric and adult patients diagnosed with chronic recurrent multifocal osteomyelitis (CRMO)/CNO or synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome treated at the Medical University of Graz.

RESULTS

24 pediatric patients diagnosed with CRMO/CNO and 10 adult patients diagnosed with SAPHO syndrome were compared. Median age at diagnosis was 12.3 years (range 7.9-18.9) in the pediatric group and 32.5 years (range 22-56) in the adult group. Median time to diagnosis was shorter in children than in adults (0.3 vs. 1.0 years). Initial clinical presentation, laboratory and histopathological findings were similar in children and adults. Mean numbers of bone lesions were comparable between pediatric and adult patients (3.1 vs. 3.0), as were rates of skin involvement (33% vs. 30%). Sternal involvement was more frequent in adults whereas involvement of clavicle and long bones was more frequent in children (41.7% vs.10, 33% vs. 10%). Computerized tomography (CT) was used more often in adults, whereas whole-body magnetic resonance imaging (MRI) was used only in children. Bisphosphonates were applied more often in children and outcome was better in children than in adults (62.5% vs.30%).

CONCLUSION

Results of our study suggest that CNO/CRMO and SAPHO syndrome in children and adults might represent a single clinical syndrome that needs a similar diagnostic and therapeutic approach.

Authors+Show Affiliations

Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria. andrea.skrabl-baumgartner@medunigraz.at.Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria.Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, Austria.Diagnostic & Research Institute of Pathology, Medical University Graz, Graz, Austria.Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University Graz, Graz, Austria.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31337412

Citation

Skrabl-Baumgartner, Andrea, et al. "Chronic Non-bacterial Osteomyelitis: a Comparative Study Between Children and Adults." Pediatric Rheumatology Online Journal, vol. 17, no. 1, 2019, p. 49.
Skrabl-Baumgartner A, Singer P, Greimel T, et al. Chronic non-bacterial osteomyelitis: a comparative study between children and adults. Pediatr Rheumatol Online J. 2019;17(1):49.
Skrabl-Baumgartner, A., Singer, P., Greimel, T., Gorkiewicz, G., & Hermann, J. (2019). Chronic non-bacterial osteomyelitis: a comparative study between children and adults. Pediatric Rheumatology Online Journal, 17(1), p. 49. doi:10.1186/s12969-019-0353-2.
Skrabl-Baumgartner A, et al. Chronic Non-bacterial Osteomyelitis: a Comparative Study Between Children and Adults. Pediatr Rheumatol Online J. 2019 Jul 23;17(1):49. PubMed PMID: 31337412.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chronic non-bacterial osteomyelitis: a comparative study between children and adults. AU - Skrabl-Baumgartner,Andrea, AU - Singer,Peter, AU - Greimel,Theresa, AU - Gorkiewicz,Gregor, AU - Hermann,Josef, Y1 - 2019/07/23/ PY - 2019/07/08/received PY - 2019/07/11/accepted PY - 2019/7/25/entrez PY - 2019/7/25/pubmed PY - 2019/7/25/medline KW - CRMO KW - Chronic non-bacterial osteomyelitis KW - SAPHO-syndrome KW - Spondyloarthritis SP - 49 EP - 49 JF - Pediatric rheumatology online journal JO - Pediatr Rheumatol Online J VL - 17 IS - 1 N2 - BACKGROUND: To compare clinical presentation, diagnostic and treatment strategies, and outcome between pediatric and adult patients with chronic non-bacterial osteomyelitis (CNO). METHODS: Retrospective single-centre comparative study of pediatric and adult patients diagnosed with chronic recurrent multifocal osteomyelitis (CRMO)/CNO or synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome treated at the Medical University of Graz. RESULTS: 24 pediatric patients diagnosed with CRMO/CNO and 10 adult patients diagnosed with SAPHO syndrome were compared. Median age at diagnosis was 12.3 years (range 7.9-18.9) in the pediatric group and 32.5 years (range 22-56) in the adult group. Median time to diagnosis was shorter in children than in adults (0.3 vs. 1.0 years). Initial clinical presentation, laboratory and histopathological findings were similar in children and adults. Mean numbers of bone lesions were comparable between pediatric and adult patients (3.1 vs. 3.0), as were rates of skin involvement (33% vs. 30%). Sternal involvement was more frequent in adults whereas involvement of clavicle and long bones was more frequent in children (41.7% vs.10, 33% vs. 10%). Computerized tomography (CT) was used more often in adults, whereas whole-body magnetic resonance imaging (MRI) was used only in children. Bisphosphonates were applied more often in children and outcome was better in children than in adults (62.5% vs.30%). CONCLUSION: Results of our study suggest that CNO/CRMO and SAPHO syndrome in children and adults might represent a single clinical syndrome that needs a similar diagnostic and therapeutic approach. SN - 1546-0096 UR - https://www.unboundmedicine.com/medline/citation/31337412/Chronic_non-bacterial_osteomyelitis:_a_comparative_study_between_children_and_adults L2 - https://ped-rheum.biomedcentral.com/articles/10.1186/s12969-019-0353-2 DB - PRIME DP - Unbound Medicine ER -