ArticleRheumatology international2016
Unexpectedly high incidences of chronic non-bacterial as compared to bacterial osteomyelitis in children.
Article in Rheumatology international, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 2 of them syntheses that pooled it.
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Who cites it
61 citing papers in PubMed, 2 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- A statistical symptomatic evaluation on SAPHO syndrome from 56 cases of confirmed diagnosis and 352 cases of non-SAPHO involvement.Clinical rheumatology · 2024Pooled it
- Whole-body magnetic resonance imaging in children - how and why? A systematic review.Pediatric radiology · 2021Pooled it
- How Organ Manifestations Beyond the Bone May Guide Risk Stratification and Treatment Decisions in Chronic Nonbacterial Osteomyelitis.Paediatric drugs · 2026Review
- A novelLife science alliance · 2026Article
- Chronic nonbacterial osteomyelitis: a typical case and review.Frontiers in pediatrics · 2026Review
- Ustekinumab as a novel treatment of chronic nonbacterial osteomyelitis: a case report.AME case reports · 2026Article
- Chronic Non-Bacterial Osteomyelitis in Pediatric Patients: Findings from Multiple Centers in Saudi Arabia.Journal of epidemiology and global health · 2025Article
- Beaten copper skull appearance in pediatric chronic nonbacterial osteomyelitis: a possible clue in the initial radiological examination.Rheumatology international · 2025Article
- Diagnostic and therapeutic insights from a cohort of chronic recurrent multifocal osteomyelitis (CRMO) patients.BMC rheumatology · 2025Article
- Assessing Disease Activity in Pediatric Chronic Nonbacterial Osteomyelitis: A Proposal for Composite Scoring, Including Inactivity Measures.ACR open rheumatology · 2025Article
- [Arthritis and osteomyelitis in childhood and adolescence-Bacterial and nonbacterial].Zeitschrift fur Rheumatologie · 2025Review
- Chronic Non-Bacterial Osteomyelitis (CNO) in a Tertiary Center in Southern Italy: Response to Treatment and Outcome Stratification.Children (Basel, Switzerland) · 2025Article
- Surgical Interventions in Chronic Recurrent Multifocal Osteomyelitis Affecting the Spine: A Case Report with Literature Review.Journal of orthopaedic case reports · 2025Article
- Evaluation of the accuracy and repeatability of Deepseek V3, Doubao, and Kimi1.5 in answering knowledge-related queries about chronic non-bacterial osteitis.Frontiers in artificial intelligence · 2025Article
- Clinical Presentation and Course of Pulmonary Involvement in Chronic Nonbacterial Osteomyelitis.ACR open rheumatology · 2025Article
- Update on the diagnosis and treatment of CNO in children: a clinician's perspective.European journal of pediatrics · 2024Review
- Chronic nonbacterial osteomyelitis in neuroradiology - behavior and evolution of vertebral and mandibular lesions on imaging.Pediatric radiology · 2024Article
- An improved understanding of pediatric chronic nonbacterial osteomyelitis pathophysiology informs current and future treatment.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024Review
- Article
- Musculoskeletal symptoms and their impact on health-related quality of life in chronic nonbacterial osteomyelitis patients.Pediatric rheumatology online journal · 2024Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Historically, osteomyelitis was considered an infectious disorder. More recently, inflammatory mechanisms were recognized causing a significant proportion of pediatric osteomyelitis. This study was to compare characteristics of children with chronic non-bacterial (CNO) and bacterial osteomyelitis (BOM). A chart review of osteomyelitis patients from the departments of pediatrics, pediatric surgery, orthopedic surgery, and oral and maxillofacial surgery was conducted in a tertiary referral center, covering the years 2004-2014. Institutional incidences of CNO (n = 49) and BOM (n = 56) were comparable. Differentiation between CNO and BOM based on clinical or laboratory findings was mostly impossible. However, children with BOM more frequently presented with local inflammatory signs (47 vs. 68 %, p = 0.040), fever (12 vs. 38 %, p = 0.003), and abscesses (0 vs. 39 %, p < 0.001). Peripheral arthritis (14 vs. 0 %, p < 0.001), inflammatory bowel disease (10 vs. 2 %, p = ns), and hyperostosis (29 vs. 4 %, p = 0.001) were more common in CNO. Whole-body MRI was performed in 76 % of CNO patients, unveiling multifocal lesions in 80 % (CRMO). Though considered a rare disorder, institutional incidences of CNO were comparable to BOM, and the discrimination between CNO and BOM solely based on clinical aspects was mostly impossible. This is of special interest, since a correct and timely diagnosis is of utmost importance for long-term outcomes in both disorders. Whole-body MRIs should be considered in chronic osteomyelitis to (1) detect clinically inapparent lesions in CNO and (2) indirectly exclude (usually unifocal) chronic bacterial infections. Prospective studies are warranted to establish evidence-based diagnostic and therapeutic approaches to CNO.
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