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Chronic Non-Bacterial Osteomyelitis

  • Christian M. HedrichEmail author
  • Hermann J. Girschick
Chapter

Abstract

Chronic non-bacterial osteomyelitis (CNO) is an autoinflammatory bone disorder originally reported in the early 1970s. It typically presents in late childhood to early adolescence with bone pain and swelling. The most commonly affected areas include the metaphyses of long bones, the clavicle and the vertebral bodies. There are no diagnostic criteria making CNO a diagnosis of exclusion. While a variety of treatments have been reported to be effective, to date there are no clinical trials upon which a firm evidence-based decision of which treatment to use can be made. Recent work in mice and humans has led to new understanding of both genetic associations and the immunologic mechanisms that appear to be involved in the pathogenesis of CNO.

Keywords

Chronic non-bacterial osteomyelitis Chronic recurrent multifocal osteomyelitis Bisphosphonates Microbiome 

Abbreviations

ASC

Apoptosis-associated speck-like protein containg a CARD

CARRA

Childhood Arthritis & Rheumatology Research Alliance

Casp1

Caspase-1

CCL

Chemokine (C-C motif) ligand

CMO

Chronic multifocal osteomyelitis

CNO

Chronic nonbacterial osteomyelitis

CRMO

Chronic recurrent multifocal osteomyelitis

CRP

C-reactive protein

DAMP

Danger-associated molecular pattern

DC

Dendritic cell

DIRA

Deficiency of the interleukin-1 receptor antagonist

DMARD

Disease modifying anti-rheumatic drug

ERK

Extracellular signal-regulated kinase

ESR

Erythrocyte sedimentation rate

FBLIM

Filamin-binding LIM protein

FBP

Formin binding protein

GM-CSF

Granulocyte and monocyte colony stimulating factor

IL

Interleukin

IL-RN

Interleukin-1 receptor antagonist

LPIN2

Lipin-2, a phosphatidate phosphatase

MAP kinase

Mitogen-activated protein kinase

MCP-1

Monocyte chemotactic protein 1 (also CCL2)

MIG

Monokine induced by gamma interferon (also CXCL9)

MIP

Macrophage inflammatory protein

MRI

Magnetic resonance imaging

MTX

Methotrexate

NF-κB

Nuclear factor-κB

NK cells

Natural killer cells

NLRP

NACHT, LRR and PYD domains-containing protein

NSAIDs

Nonsteroidal anti-inflammtory drugs

PAMP

Pathogen-associated molecular pattern

PAPA

Pyoderma gangrenosum and acne syndrome

PBMC

Peripheral blood mononuclear cells

PRRs

Pattern recognition receptors

Pstpip

Proline-serine-threonine phosphatase-interacting protein

RANK

Receptor activator of nuclear factor-κB

RANKL

Receptor activator of nuclear factor-κB ligand

RANTES

Regulated on activation, normal T cell expressed and secreted protein (also CCL5)

SAPHO

Synovitis acne pustulosis hyperostosis osteitis syndrome

STAT

Signal transducer and activator of transcription

sJIA

Systemic juvenile idiopathic arthritis

TIRM

Turbo inversion recovery measurement

TNF

Tumor necrosis factor

VAS

Visual analogue scale

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Christian M. Hedrich
    • 1
    • 2
    • 3
    Email author
  • Hermann J. Girschick
    • 4
  1. 1.Pediatric Rheumatology and Immunology, Department of PediatricsMedizinische Fakultät Carl Gustav Carus, Technische Universität DresdenDresdenGermany
  2. 2.Department of Women’s and Children’s Health, Institute of Translational MedicineUniversity of LiverpoolLiverpoolUK
  3. 3.Department of Paediatric RheumatologyAlder Hey Children’s NHS Foundation Trust HospitalLiverpoolUK
  4. 4.Vivantes Klinikum Friedrichshain, Children’s HospitalBerlinGermany

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