Published in:
Open Access
01-12-2021 | Magnetic Resonance Imaging | Educational Review
Imaging in non-bacterial osteomyelitis in children and adolescents: diagnosis, differential diagnosis and follow-up—an educational review based on a literature survey and own clinical experiences
Authors:
Matthias C. Schaal, Liya Gendler, Bettina Ammann, Nina Eberhardt, Aleš Janda, Henner Morbach, Kassa Darge, Hermann Girschick, Meinrad Beer
Published in:
Insights into Imaging
|
Issue 1/2021
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Abstract
Background
Chronic non-bacterial osteomyelitis (CNO) is an autoinflammatory bone disorder affecting children and adolescents. Previously classified as a rare disease, recent studies suggest a higher incidence of the disease. CNO may develop into the clinical presentation of chronic recurrent osteomyelitis (CRMO) with high relapse rate and multifocality.
Main body
Diagnosis of CNO/CRMO is often delayed, with implications for disease severity and relapse rate. This can be significantly improved by knowledge of the disease entity and its characteristics. Imaging plays a key role in diagnosis, differential diagnosis and therapy monitoring. Magnetic resonance imaging (MRI) has several advantages compared to other imaging methods and is increasingly applied in clinical studies. Recent studies show that a whole-body (WB) coverage (WB-MRI) without contrast agent administration is a rational approach. This educational review is based on a systematic analysis of international peer-reviewed articles and presents our own clinical experiences. It provides an overview of disease entity, incidence and clinical diagnosis. The role of imaging, especially of whole-body MRI, is discussed in detail. Finally, practical advice for imaging, including flowcharts explaining when and how to apply imaging, is provided.
Conclusion
Knowing the specifics of CNO/CRMO and the importance of MRI/whole-body MRI allows rapid and efficient diagnosis as well as therapy support and helps to avoid irreversible secondary damage.