European Radiology

, Volume 27, Issue 6, pp 2391–2399 | Cite as

Whole-body MRI in patients with Non-bacterial Osteitis: Radiological findings and correlation with clinical data

  • A. P. Arnoldi
  • C. L. Schlett
  • H. Douis
  • L. L. Geyer
  • A. M. Voit
  • F. Bleisteiner
  • A. F. Jansson
  • S. Weckbach
Magnetic Resonance



To correlate clinical findings of Non-bacterial Osteitis (NBO) with whole-body MRI (WB-MRI) findings and determine a radiologic index for NBO (RINBO) which allows standardized reporting of WB-MRI.

Methods and materials

In a prospective study, 40 patients with diagnosis of NBO underwent clinical examination and WB-MRI in which STIR- and T1- weighted images were assessed for NBO-typical lesions. Parameters of interest for RINBO were: number of radiologically active lesions (RAL), size of the patients’ maximum RAL presence of extramedullary and spinal involvement. Results were tested for statistical agreement of clinical and MR-based lesion detection. RINBO was tested for correlation with clinical activity.


62/95 clinically/radiologically active lesions were found in 30/33 patients. In 45 % of the cohort, more active lesions were detected by WB-MRI than by clinical examination. RINBO was a significant predictor for the presence of clinically active lesions.


WB-MRI is a powerful diagnostic tool for patients with NBO which can reveal asymptomatic disease activity. With RINBO a standardized evaluation approach is proposed which helps assessing radiologic disease burden and predicts clinical disease activity.

Key Points

Whole body MRI is a powerful diagnostic tool for patients with non-bacterial Osteitis.

Whole body MRI can reveal asymptomatic disease activity.

The radiologic index RINBO offers a standardized evaluation approach.


Whole body imaging Magnetic resonance imaging Non-bacterial Osteitis CRMO Activity score 



Non-bacterial Osteitis


Chronic Recurrent Multifocal Osteomyelitis


Whole Body Magnetic Resonance Imaging


Radiologic index for Non-bacterial Osteitis




Clinically active lesions


Visual analogue scale


C-reactive protein


Erythrocyte sedimentation rate


Short tau inversion recovery


Diffusion weighted Imaging


Radiologically active lesions


Radiologically not active lesions


Signal intensity


Parameter of interest


Lesions per patient


Area under the curve



The scientific guarantor of this publication is PD Dr. Annette Jansson. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have been previously reported in: Voit AM, Arnoldi AP, Douis H et al (2015) Whole-body Magnetic Resonance Imaging in Chronic Recurrent Multifocal Osteomyelitis: Clinical Longterm Assessment May Underestimate Activity. J Rheumatol 42:1455-1462. Methodology: prospective, diagnostic study, performed at one institution.


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • A. P. Arnoldi
    • 1
  • C. L. Schlett
    • 2
  • H. Douis
    • 3
  • L. L. Geyer
    • 1
  • A. M. Voit
    • 4
  • F. Bleisteiner
    • 4
  • A. F. Jansson
    • 4
  • S. Weckbach
    • 2
  1. 1.Institute for Clinical Radiology, Ludwig-Maximilians-University HospitalMunichGermany
  2. 2.Diagnostic and Interventional RadiologyUniversity Hospital HeidelbergHeidelbergGermany
  3. 3.Department of RadiologyUniversity Hospital BirminghamBirminghamUnited Kingdom
  4. 4.Department of Rheumatology & ImmunologyDr. von Hauner Children’s Hospital, Ludwig-Maximilians-UniversityMunichGermany

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