Title:Chronic Non-bacterial Osteomyelitis (CNO) In Childhood: A Review
Volume: 20
Issue: 4
Author(s): Fiona Price-Kuehne and Kate Armon*
Affiliation:
- Department of Paediatrics, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
Keywords:
Autoinflammatory bone disorder, chronic nonbacterial osteomyelitis, chronic recurrent multifocal osteomyelitis, clinical features, current concepts in pathophysiology, investigation and management.
Abstract:
Chronic non-bacterial osteomyelitis (CNO) is an autoinflammatory bone disorder mostly
affecting children and adolescents. Although it is considered a rare disease, CNO is likely to be the
single most common autoinflammatory bone disease in childhood, underdiagnosed and underreported
due to a lack of awareness of the condition in both medics and patients and the absence of
validated diagnostic criteria. The exact underlying pathogenesis of CNO remains unknown, making
targeted treatment difficult. This issue is exacerbated by the lack of any randomised control trials,
meaning that treatment strategies are based solely on retrospective reviews and case series.
This review summarises the current concepts in pathophysiology, the clinical features that help differentiate
important differential diagnoses, and an approach to investigating and managing children
with CNO. Ultimately, the timely and thorough investigation of children and young people with
CNO is vitally important to exclude important mimics and initiate appropriate management that can
prevent the complications of persistent inflammatory bone disease.
