Study Identifies Clinical Characteristics of Chronic Nonbacterial Osteomyelitis

According to a story from EurekAlert! a recent study presented at the annual meeting of the American College of Rheumatology describes some of the key clinical feature of chronic nonbacterial osteomyelitis, an illness that impacts young adults and children around the world. This disease is also called chronic recurrent multifocal osteomyelitis. At this juncture, there are no widely accepted classification criteria for this disease. This means that physicians do not have concrete guidelines to help diagnose patients, who could benefit from participation in research and clinical trials.

About Chronic Nonbacterial Osteomyelitis

Chronic nonbacterial osteomyelitis is a rare disease affecting the bones that is primarily characterized by inflammation, lesions appearing on the bones, and pain. While the origins of the disease aren’t entirely clear, it is often described as an autoimmune or autoinflammatory disease, meaning that it is the result of the immune system mistakenly attacking healthy tissue. It presents similarly to standard osteomyelitis (infection of bone) but without the presence of an actual infection. Diagnosis is difficult and many other diseases must be ruled out before one can be made. Symptoms include chronic pain, bone inflammation, bone overgrowth, fatigue, swelling, arthritis, breakdown of bones, weight loss, and other bone abnormalities. Treatment is primarily aimed at controlling inflammation; treatment includes non-steroidal anti-inflammatory drugs (NSAIDs) and steroids. Patient response to these approaches is inconsistent. To learn more about chronic nonbacterial osteomyelitis, click here.

About The Study

Often a bone biopsy is necessary in order to distinguish this disease from others that trigger similar symptoms. The researchers compared the laboratory, clinical, and imaging characteristics of the disease side by side with other illnesses that resemble it. The international study used data from 450 different patients with the disease as well as patients with diseases that resemble chronic nonbacterial osteomyelitis. 

The scientists found that there was an unexpectedly high percentage of female patients with the disease. In addition, they found that patients tended to have intermittent pain as opposed to steady pain. Fevers and arthritis were uncommon. Pain was often present in the upper torso, back, and neck. Many patients also displayed a swollen clavicle (collarbone). Other bones most often involved in the disease included the thoracic spine, pelvis, bilateral femur, feet, unilateral fibula, and bilateral tibia.

Chronic nonbacterial osteomyelitis patients were also less likely to show indicators of actual bone infection and sustained response to antibiotics was uncommon. With the findings from this, study, useful criteria could be developed to help consistently diagnose this disease.

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