Chronic non-bacterial osteomyelitis (CNO) in childhood and adolescence – a disease with many faces

Abstract

Background Chronic non-bacterial osteomyelitis (CNO) is a chronic inflammatory skeletal disease that affects particularly children and adolescents and is often diagnosed with a delay. With whole-body MRI, early diagnosis of this disease is possible in many cases. Since children and adolescents frequently present with non-specific complaints for outpatient radiological diagnosis, every radiologist should have basic knowledge of this complex clinical picture.

Materials In this review the basics and current findings regarding the disease are discussed. Unusual courses are also presented.

Results and Conclusion With knowledge of the radiographic and MR tomographic characteristics of the mostly multifocal bone lesions, the diagnosis of CNO can be reliably made in many cases. In particular, the early use of whole-body MRI plays an important role. Thus, therapeutic delays and resulting complications and the number of unnecessary biopsies for diagnosis can be reduced.

Keywords: 

• Chronic non-bacterial osteomyelitis is a chronic inflammatory skeletal disease, especially in children and adolescents. The incidence has long been underestimated

• The location of the lesions, especially in metaphyses and metaphyseal equivalent regions, as well as the distribution pattern of the clinically often occult lesions are decisive for diagnosis

• Whole-body MRI plays an important role in the diagnostic workup as it reveals the characteristic distribution pattern of the lesions and helps to confirm the diagnosis

• Differentiated radiological diagnosis can reduce the number of biopsies and reduce long-term complications of the disease by early diagnosis and initiation of therapy

Key words

bones - MR-imaging - inflammation - radiography

Publikationsverlauf

Eingereicht: 19. März 2023

Angenommen: 01. Juli 2023

Artikel online veröffentlicht:
12. September 2023

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