Chronic Non-Bacterial Osteomyelitis

  • Christian M. HedrichEmail author
  • Hermann J. Girschick


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.


Chronic non-bacterial osteomyelitis Chronic recurrent multifocal osteomyelitis Bisphosphonates Microbiome 



Apoptosis-associated speck-like protein containg a CARD


Childhood Arthritis & Rheumatology Research Alliance




Chemokine (C-C motif) ligand


Chronic multifocal osteomyelitis


Chronic nonbacterial osteomyelitis


Chronic recurrent multifocal osteomyelitis


C-reactive protein


Danger-associated molecular pattern


Dendritic cell


Deficiency of the interleukin-1 receptor antagonist


Disease modifying anti-rheumatic drug


Extracellular signal-regulated kinase


Erythrocyte sedimentation rate


Filamin-binding LIM protein


Formin binding protein


Granulocyte and monocyte colony stimulating factor




Interleukin-1 receptor antagonist


Lipin-2, a phosphatidate phosphatase

MAP kinase

Mitogen-activated protein kinase


Monocyte chemotactic protein 1 (also CCL2)


Monokine induced by gamma interferon (also CXCL9)


Macrophage inflammatory protein


Magnetic resonance imaging




Nuclear factor-κB

NK cells

Natural killer cells


NACHT, LRR and PYD domains-containing protein


Nonsteroidal anti-inflammtory drugs


Pathogen-associated molecular pattern


Pyoderma gangrenosum and acne syndrome


Peripheral blood mononuclear cells


Pattern recognition receptors


Proline-serine-threonine phosphatase-interacting protein


Receptor activator of nuclear factor-κB


Receptor activator of nuclear factor-κB ligand


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


Synovitis acne pustulosis hyperostosis osteitis syndrome


Signal transducer and activator of transcription


Systemic juvenile idiopathic arthritis


Turbo inversion recovery measurement


Tumor necrosis factor


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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