Evidence map›Paper›PMID 40858879›Full record

ArticleClinical rheumatology2025

Validation of the EULAR/ACR classification criteria for chronic nonbacterial osteomyelitis in a pediatric cohort.

Dilara Unal, Yasemin Demir Yigit, Ozge Basaran, Adalet Elcin Yildiz, Yagmur Bayindir, Veysel Cam, Hülya Ercan Emreol, Mehmet Orhan Erkan, Ozlem Necipoglu Banak, Erdal Sag and 3 more

Abstract readValidation Study
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Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Dilara UnalDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.ORCID http://orcid.org/0000-0002-3043-792X
Yasemin Demir YigitDivision of Pediatric Rheumatology, Faculty of Medicine, Fırat University, Elazig, Turkey.
Ozge BasaranDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.
Adalet Elcin YildizDivision of Musculoskeletal Radiology, Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.
Yagmur BayindirDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.
Veysel CamDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.
Hülya Ercan EmreolDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.
Mehmet Orhan ErkanDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.
Ozlem Necipoglu BanakDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.
Erdal SagDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.
Yelda BilginerDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.
Ustun AydingozDivision of Musculoskeletal Radiology, Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.
Seza OzenDepartment of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey. sezaozen@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesChronic nonbacterial osteomyelitis (CNO) is a rare autoinflammatory bone disorder primarily affecting children and adolescents. An international consensus group developed the EULAR/ACR Classification Criteria in order to define a homogeneous group of patients diagnosed with CNO. This study aims to validate these criteria in a diverse pediatric cohort and compare their performance with the Jansson and Roderick diagnostic criteria.

methodsA retrospective evaluation was conducted on 78 pediatric CNO patients and 99 mimickers in Hacettepe University department of pediatric Rheumatology from 2020 to 2024. Demographic, clinical, laboratory, and imaging data were analyzed, and the sensitivity, specificity, and predictive values of the EULAR/ACR criteria were assessed. Statistical comparisons were made against the Jansson and Roderick criteria.

resultsThe EULAR/ACR criteria demonstrated high accuracy, with a sensitivity of 92.68% and specificity of 97.89%, outperforming the Jansson criteria (sensitivity: 88.46%, specificity: 72.73%) and aligning closely with the Roderick criteria (sensitivity: 96.15%, specificity: 96.97%). Key distinguishing features included multifocal and symmetric lesions, frequent involvement of high-scoring anatomical sites (e.g., clavicle and mandible), and the absence of exclusion criteria such as fever and markedly elevated inflammatory markers.

conclusionsThe newly validated EULAR/ACR classification criteria for pediatric CNO demonstrated high specificity and good sensitivity in our cohort. Their application facilitates the identification of homogeneous patient populations, aiding in research consistency and the development of standardized approaches to CNO classification and management. Key Points • The EULAR/ACR classification criteria for pediatric CNO exhibited high specificity (97.89%) and sensitivity (92.68%), supporting their validity. • Multifocal and symmetric bone lesions, particularly in the clavicle and mandible, strongly support classification under these criteria. • Validation in a pediatric cohort reinforces their utility for standardized patient classification and research consistency.

Indexed as

OsteomyelitisAdolescentChildChild, PreschoolChronic DiseaseFemaleHumansMaleRetrospective StudiesSensitivity and SpecificityChronic nonbacterial osteomyelitisClassification criteriaValidation

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