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Arthritis und Rheuma 2013; 33(06): 371-376
DOI: 10.1055/s-0037-1618200
Alltägliches in der kinderrheumatologischen Praxis?
Schattauer GmbH

Nichtbakterielle Osteitiden

Aktueller Wissensstand und TherapieoptionenNonbacterial OsteitisUpdate and therapeutic options
A. F. Jansson
1   Kinderklinik und Poliklinik, Dr. von Haunersches Kinderspital, Klinikum Innenstadt, Universität München
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Publication History

Publication Date:
27 December 2017 (online)

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Zusammenfassung

Der Begriff „Nichtbakterielle Osteitis (NBO)“ steht für autoinflammatorische Knochenentzündungen. Diese verlaufen in aller Regel chronisch, können sich jedoch mitunter auch als kurze, vorübergehende Episode manifestieren. Nichtbakterielle Osteitiden stellen eine wichtige Differenzialdiagnose zur bakteriellen Osteomyelitis (BO) dar. Sie können in allen Altersklassen auftreten und als „Knochenrheuma“ betrachtet werden. Neuere Untersuchungen zeigen, dass die bakterielle Osteomyelitis bei sonst gesunden Patienten deutlich seltener vorkommt als die NBO. Bei der Diagnose NBO handelt es sich derzeit noch um eine Ausschlussdiagnose, da genetische oder andere spezifische diagnostische Parameter fehlen. Hier können Diagnosekriterien und ein Diagnostikplan hilfreich sein. Die Therapie ist vorwiegend symptomatisch. Es besteht Konsens, primär NSAR einzusetzen. Bisphosphonate und Biologika stellen bei Wirbelkörperbefall oder Therapieresistenz weitere Optionen dar.

Summary

The term „Nonbacterial Osteits“ (NBO) describes autoinflammatory bone lesions. In a few patients those osteitic lesions occur as an acute flare and vanish spontaneously. But in the majority of cases the disease takes a chronic course. Bacterial osteomyelitis (BO) is an important differential diagnosis. NBO can affect children and adults and may be described as „bone rheumatism“. A recent report shows that in otherwise healthy patients NBO seems to occur more frequently than BO. As genetic or other specific diagnostic parameters are lacking NBO is a diagnosis of exclusion and a diagnostic challenge. Diagnostic criteria and schedules can be helpful. Therapy is symptomatic. Nonsteroidals are the medication of choice. In patients with vertebral involvement or resistant courses bisphosphonates or anti-TNF agents are additional treatment options.

Schlüsselwörter

NBO - CRMO - CNO - SAPHO-Syndrom

Keywords

NBO - CRMO - CNO - SAPHO-Syndrom
 

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