Chronic non-bacterial osteomyelitis: a retrospective international study on clinical manifestations and response to treatment.
Clin Exp Rheumatol
; 38(6): 1255-1262, 2020.
Article
em En
| MEDLINE
| ID: mdl-32828142
ABSTRACT
OBJECTIVES:
Chronic non-bacterial osteomyelitis (CNO) is a rare non-infectious bone inflammatory disorder; when multifocal, it is referred to as Chronic Recurrent Multifocal Osteomyelitis (CRMO). This study evaluates the demographic, clinical and radiological characteristics of a multi-centre cohort of patients with CNO/CRMO.METHODS:
Demographic and clinical data of patients with an established diagnosis of CNO/CRMO followed at paediatric rheumatology centres across Europe (Italy, France, Slovenia) and India were retrospectively collected.RESULTS:
There were no demographic differences across countries, but time to diagnosis was significantly longer in India (p=0.041). Pain was almost invariably present at disease onset; functional impairment was more frequent among Italian and Slovenian patients (p=0.001). The number of sites of bone involvement was similar between genders and countries, with long bone metaphises being the most common site. Raised acute phase reactants, detected in >50% of patients, were not associated with clinical manifestations or response to treatment. Comorbidities, evinced in 37% of patients, were equally distributed between genders and nationalities. Imaging approach was similar across countries, without any association between radiological findings and clinical manifestations. NSAIDs were almost invariably used as first-line treatment, but response rate was significantly lower in Italy (p=0.02). Methotrexate was used in 28% of case, with an overall rate of response of 82%. Health conditions and rate of permanent deformities were similar across different countries.CONCLUSIONS:
The differences in clinical presentation, radiological features and response to treatment described in this multinational cohort of CNO/CRMO might provide novel insights into this still elusive disease.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteomielite
Tipo de estudo:
Observational_studies
Limite:
Child
/
Female
/
Humans
/
Male
País/Região como assunto:
Asia
/
Europa
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article