Whole-body MRI in patients with Non-bacterial Osteitis: Radiological findings and correlation with clinical data
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.
• 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.
KeywordsWhole body imaging Magnetic resonance imaging Non-bacterial Osteitis CRMO Activity score
Chronic Recurrent Multifocal Osteomyelitis
Whole Body Magnetic Resonance Imaging
Radiologic index for Non-bacterial Osteitis
Clinically active lesions
Visual analogue scale
Erythrocyte sedimentation rate
Short tau inversion recovery
Diffusion weighted Imaging
Radiologically active lesions
Radiologically not active lesions
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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