Characteristics of chronic non-bacterial osteomyelitis in children living in the Novosibirsk region

Abstract

Background. Chronic non-bacterial osteomyelitis (CNO) is a rare autoinflammatory bone disease that has been insufficiently studied and described in the scientific medical literature. Due to the lack of specific laboratory and instrumental criteria, a complex interdisciplinary differential diagnosis is required. Aim. To study the clinical manifestations of the onset of the disease, the features of the course, and the results of laboratory and instrumental diagnostic methods in pediatric patients living in the Novosibirsk region diagnosed with CNO. Materials and methods. A retro- and prospective observational study was conducted, and inpatient records were analyzed in patients under 18 with a documented diagnosis of CNO, SAPHO syndrome, and hospitalized in the State Novosibirsk Regional Clinical Hospital departments. Results. In the Novosibirsk region, relatively early detection of CNO is carried out, with an average diagnostic gap of about six months. Less than half (34%) of the patients from the observation group were referred to a pediatric rheumatologist at the initial visit for bone pain despite the presence of concomitant articular syndrome in most of them (70%). The most common affected area in CNO is the spine (30%), followed by the femur (19%) and pelvis (16%). Notably, at the onset of the disease, monofocal bone tissue lesions were common (52%). Pain and loss of function in the bone lesion area were typical complaints in all patients with CNO. Articular syndrome was also common. Conclusion. CNO, being a rare autoinflammatory disease, requires a relatively complex multidiscipline differential diagnosis; its outcomes largely depend on the timing of the diagnosis.