Skip to main content
Top
Published in:

Open Access 01-12-2017 | Mini review

The molecular pathophysiology of chronic non-bacterial osteomyelitis (CNO)—a systematic review

Authors: Sigrun Ruth Hofmann, Franz Kapplusch, Katrin Mäbert, Christian Michael Hedrich

Published in: Molecular and Cellular Pediatrics | Issue 1/2017

Login to get access

Abstract

Chronic non-bacterial osteomyelitis (CNO) belongs to the growing spectrum of autoinflammatory diseases and primarily affects the skeletal system. Peak onset ranges between 7 and 12 years of age. The clinical spectrum of CNO covers sometimes asymptomatic inflammation of single bones at the one end and chronically active or recurrent multifocal osteitis at the other.
Despite the intense scientific efforts, the exact molecular mechanisms of CNO remain unknown. Recent data suggest CNO as a genetically complex disorder with dysregulated TLR4/MAPK/inflammasome signaling cascades resulting in an imbalance between pro- and anti-inflammatory cytokine expression, leading to osteoclast activation and osteolytic lesions.
In this manuscript, the current understanding of molecular patho-mechanisms in CNO will be discussed.
Literature
1.
2.
go back to reference Ferguson PJ, Sandu M (2012) Current understanding of the pathogenesis and management of chronic recurrent multifocal osteomyelitis. Curr Rheumatol Rep 14:130–41CrossRefPubMedPubMedCentral Ferguson PJ, Sandu M (2012) Current understanding of the pathogenesis and management of chronic recurrent multifocal osteomyelitis. Curr Rheumatol Rep 14:130–41CrossRefPubMedPubMedCentral
3.
go back to reference Girschick HJ, Zimmer C, Klaus G, Darge K, Dick A, Morbach H (2007) Chronic recurrent multifocal osteomyelitis: what is it and how should it be treated? Nat Clin Pract Rheumatol 3:733–8CrossRefPubMed Girschick HJ, Zimmer C, Klaus G, Darge K, Dick A, Morbach H (2007) Chronic recurrent multifocal osteomyelitis: what is it and how should it be treated? Nat Clin Pract Rheumatol 3:733–8CrossRefPubMed
4.
go back to reference Hedrich CM, Hahn G, Girschick HJ, Morbach H (2013) A clinical and pathomechanistic profile of chronic nonbacterial osteomyelitis/chronic recurrent multifocal osteomyelitis and challenges facing the field. Expert Rev Clin Immunol 9:845–54CrossRefPubMed Hedrich CM, Hahn G, Girschick HJ, Morbach H (2013) A clinical and pathomechanistic profile of chronic nonbacterial osteomyelitis/chronic recurrent multifocal osteomyelitis and challenges facing the field. Expert Rev Clin Immunol 9:845–54CrossRefPubMed
5.
go back to reference Hedrich CM, Hofmann SR, Pablik J, Morbach H, Girschick HJ (2013) Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J 11:47CrossRefPubMedPubMedCentral Hedrich CM, Hofmann SR, Pablik J, Morbach H, Girschick HJ (2013) Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J 11:47CrossRefPubMedPubMedCentral
6.
go back to reference Hofmann SR, Schnabel A, Rosen-Wolff A, Morbach H, Girschick HJ, Hedrich CM (2016) Chronic nonbacterial osteomyelitis: pathophysiological concepts and current treatment strategies. J Rheumatol 43:1956–64CrossRefPubMed Hofmann SR, Schnabel A, Rosen-Wolff A, Morbach H, Girschick HJ, Hedrich CM (2016) Chronic nonbacterial osteomyelitis: pathophysiological concepts and current treatment strategies. J Rheumatol 43:1956–64CrossRefPubMed
7.
go back to reference Schnabel A, Range U, Hahn G, Siepmann T, Berner R, Hedrich CM (2016) Unexpectedly high incidences of chronic non-bacterial as compared to bacterial osteomyelitis in children. Rheumatol Int 36:1737–45CrossRefPubMed Schnabel A, Range U, Hahn G, Siepmann T, Berner R, Hedrich CM (2016) Unexpectedly high incidences of chronic non-bacterial as compared to bacterial osteomyelitis in children. Rheumatol Int 36:1737–45CrossRefPubMed
8.
go back to reference Ferguson PJL, RM (2016) Autoinflammatory Bone Disorders. In: Petty L, Lindsley, Wedderburn, editor. Textbook of Pediatric Rheumatology. 7th Edition. Elsevier, Philadelphia, pp 627–41 Ferguson PJL, RM (2016) Autoinflammatory Bone Disorders. In: Petty L, Lindsley, Wedderburn, editor. Textbook of Pediatric Rheumatology. 7th Edition. Elsevier, Philadelphia, pp 627–41
9.
go back to reference Hofmann SRK F, Girschick HJ, Morbach H, Pablik J, Ferguson PJ, Hedrich CM (2017) Chronic recurrent multi-focal osteomyelitis (CRMO): presentation, pathogenesis and treatment. Curr Osteoporos Rep. in press. Hofmann SRK F, Girschick HJ, Morbach H, Pablik J, Ferguson PJ, Hedrich CM (2017) Chronic recurrent multi-focal osteomyelitis (CRMO): presentation, pathogenesis and treatment. Curr Osteoporos Rep. in press.
10.
go back to reference Huber AM, Lam PY, Duffy CM, Yeung RS, Ditchfield M, Laxer D et al (2002) Chronic recurrent multifocal osteomyelitis: clinical outcomes after more than five years of follow-up. J Pediatr 141:198–203CrossRefPubMed Huber AM, Lam PY, Duffy CM, Yeung RS, Ditchfield M, Laxer D et al (2002) Chronic recurrent multifocal osteomyelitis: clinical outcomes after more than five years of follow-up. J Pediatr 141:198–203CrossRefPubMed
11.
go back to reference Jansson A, Renner ED, Ramser J, Mayer A, Haban M, Meindl A et al (2007) Classification of non-bacterial osteitis: retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatology (Oxford) 46:154–60CrossRef Jansson A, Renner ED, Ramser J, Mayer A, Haban M, Meindl A et al (2007) Classification of non-bacterial osteitis: retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatology (Oxford) 46:154–60CrossRef
12.
go back to reference Hofmann SR, Roesen-Wolff A, Hahn G, Hedrich CM (2012) Update: cytokine dysregulation in chronic nonbacterial osteomyelitis (CNO). Int J Rheumatol 2012:310206CrossRefPubMedPubMedCentral Hofmann SR, Roesen-Wolff A, Hahn G, Hedrich CM (2012) Update: cytokine dysregulation in chronic nonbacterial osteomyelitis (CNO). Int J Rheumatol 2012:310206CrossRefPubMedPubMedCentral
13.
go back to reference Morbach H, Hedrich CM, Beer M, Girschick HJ (2013) Autoinflammatory bone disorders. Clin Immunol 147:185–96CrossRefPubMed Morbach H, Hedrich CM, Beer M, Girschick HJ (2013) Autoinflammatory bone disorders. Clin Immunol 147:185–96CrossRefPubMed
14.
go back to reference Hofmann SR, Kubasch AS, Range U, Laass MW, Morbach H, Girschick HJ et al (2016) Serum biomarkers for the diagnosis and monitoring of chronic recurrent multifocal osteomyelitis (CRMO). Rheumatol Int 36:769–79CrossRefPubMed Hofmann SR, Kubasch AS, Range U, Laass MW, Morbach H, Girschick HJ et al (2016) Serum biomarkers for the diagnosis and monitoring of chronic recurrent multifocal osteomyelitis (CRMO). Rheumatol Int 36:769–79CrossRefPubMed
15.
go back to reference Hofmann SR, Schwarz T, Moller JC, Morbach H, Schnabel A, Rosen-Wolff A et al (2011) Chronic non-bacterial osteomyelitis is associated with impaired Sp1 signaling, reduced IL10 promoter phosphorylation, and reduced myeloid IL-10 expression. Clin Immunol 141:317–27CrossRefPubMed Hofmann SR, Schwarz T, Moller JC, Morbach H, Schnabel A, Rosen-Wolff A et al (2011) Chronic non-bacterial osteomyelitis is associated with impaired Sp1 signaling, reduced IL10 promoter phosphorylation, and reduced myeloid IL-10 expression. Clin Immunol 141:317–27CrossRefPubMed
17.
go back to reference Hofmann SR, Rosen-Wolff A, Tsokos GC, Hedrich CM (2012) Biological properties and regulation of IL-10 related cytokines and their contribution to autoimmune disease and tissue injury. Clin Immunol 143:116–27CrossRefPubMed Hofmann SR, Rosen-Wolff A, Tsokos GC, Hedrich CM (2012) Biological properties and regulation of IL-10 related cytokines and their contribution to autoimmune disease and tissue injury. Clin Immunol 143:116–27CrossRefPubMed
18.
go back to reference Hofmann SR, Morbach H, Schwarz T, Rosen-Wolff A, Girschick HJ, Hedrich CM (2012) Attenuated TLR4/MAPK signaling in monocytes from patients with CRMO results in impaired IL-10 expression. Clin Immunol 145:69–76CrossRefPubMed Hofmann SR, Morbach H, Schwarz T, Rosen-Wolff A, Girschick HJ, Hedrich CM (2012) Attenuated TLR4/MAPK signaling in monocytes from patients with CRMO results in impaired IL-10 expression. Clin Immunol 145:69–76CrossRefPubMed
19.
go back to reference Hedrich CM, Crispin JC, Tsokos GC (2014) Epigenetic regulation of cytokine expression in systemic lupus erythematosus with special focus on T cells. Autoimmunity 47:234–41CrossRefPubMed Hedrich CM, Crispin JC, Tsokos GC (2014) Epigenetic regulation of cytokine expression in systemic lupus erythematosus with special focus on T cells. Autoimmunity 47:234–41CrossRefPubMed
20.
go back to reference Hedrich CM, Mabert K, Rauen T, Tsokos GC (2017) DNA methylation in systemic lupus erythematosus. Epigenomics 9:505–25CrossRefPubMed Hedrich CM, Mabert K, Rauen T, Tsokos GC (2017) DNA methylation in systemic lupus erythematosus. Epigenomics 9:505–25CrossRefPubMed
21.
go back to reference Hedrich CM, Ramakrishnan A, Dabitao D, Wang F, Ranatunga D, Bream JH (2010) Dynamic DNA methylation patterns across the mouse and human IL10 genes during CD4+ T cell activation: influence of IL-27. Mol Immunol 48:73–81CrossRefPubMedPubMedCentral Hedrich CM, Ramakrishnan A, Dabitao D, Wang F, Ranatunga D, Bream JH (2010) Dynamic DNA methylation patterns across the mouse and human IL10 genes during CD4+ T cell activation: influence of IL-27. Mol Immunol 48:73–81CrossRefPubMedPubMedCentral
22.
go back to reference Hofmann SR, Kubasch AS, Ioannidis C, Rosen-Wolff A, Girschick HJ, Morbach H et al (2015) Altered expression of IL-10 family cytokines in monocytes from CRMO patients result in enhanced IL-1beta expression and release. Clin Immunol 161:300–7CrossRefPubMed Hofmann SR, Kubasch AS, Ioannidis C, Rosen-Wolff A, Girschick HJ, Morbach H et al (2015) Altered expression of IL-10 family cytokines in monocytes from CRMO patients result in enhanced IL-1beta expression and release. Clin Immunol 161:300–7CrossRefPubMed
23.
go back to reference Greenhill CJ, Jones GW, Nowell MA, Newton Z, Harvey AK, Moideen AN et al (2014) Interleukin-10 regulates the inflammasome-driven augmentation of inflammatory arthritis and joint destruction. Arthritis Res Ther 16:419CrossRefPubMedPubMedCentral Greenhill CJ, Jones GW, Nowell MA, Newton Z, Harvey AK, Moideen AN et al (2014) Interleukin-10 regulates the inflammasome-driven augmentation of inflammatory arthritis and joint destruction. Arthritis Res Ther 16:419CrossRefPubMedPubMedCentral
24.
go back to reference Scianaro R, Insalaco A, Bracci Laudiero L, De Vito R, Pezzullo M, Teti A et al (2014) Deregulation of the IL-1beta axis in chronic recurrent multifocal osteomyelitis. Pediatr Rheumatol Online J 12:30CrossRefPubMedPubMedCentral Scianaro R, Insalaco A, Bracci Laudiero L, De Vito R, Pezzullo M, Teti A et al (2014) Deregulation of the IL-1beta axis in chronic recurrent multifocal osteomyelitis. Pediatr Rheumatol Online J 12:30CrossRefPubMedPubMedCentral
25.
go back to reference Nakashima T, Takayanagi H (2009) Osteoimmunology: crosstalk between the immune and bone systems. J Clin Immunol 29:555–67CrossRefPubMed Nakashima T, Takayanagi H (2009) Osteoimmunology: crosstalk between the immune and bone systems. J Clin Immunol 29:555–67CrossRefPubMed
26.
27.
go back to reference El-Shanti H, Ferguson P (1993) Majeed Syndrome El-Shanti H, Ferguson P (1993) Majeed Syndrome
28.
go back to reference Ferguson PJ, Chen S, Tayeh MK, Ochoa L, Leal SM, Pelet A et al (2005) Homozygous mutations in LPIN2 are responsible for the syndrome of chronic recurrent multifocal osteomyelitis and congenital dyserythropoietic anaemia (Majeed syndrome). J Med Genet 42:551–7CrossRefPubMedPubMedCentral Ferguson PJ, Chen S, Tayeh MK, Ochoa L, Leal SM, Pelet A et al (2005) Homozygous mutations in LPIN2 are responsible for the syndrome of chronic recurrent multifocal osteomyelitis and congenital dyserythropoietic anaemia (Majeed syndrome). J Med Genet 42:551–7CrossRefPubMedPubMedCentral
29.
go back to reference Aksentijevich I, Masters SL, Ferguson PJ, Dancey P, Frenkel J, van Royen-Kerkhoff A et al (2009) An autoinflammatory disease with deficiency of the interleukin-1-receptor antagonist. N Engl J Med 360:2426–37CrossRefPubMedPubMedCentral Aksentijevich I, Masters SL, Ferguson PJ, Dancey P, Frenkel J, van Royen-Kerkhoff A et al (2009) An autoinflammatory disease with deficiency of the interleukin-1-receptor antagonist. N Engl J Med 360:2426–37CrossRefPubMedPubMedCentral
30.
go back to reference Ferguson PJ, Laxer RM (2015) New discoveries in CRMO: IL-1beta, the neutrophil, and the microbiome implicated in disease pathogenesis in Pstpip2-deficient mice. Semin Immunopathol 37:407–12CrossRefPubMed Ferguson PJ, Laxer RM (2015) New discoveries in CRMO: IL-1beta, the neutrophil, and the microbiome implicated in disease pathogenesis in Pstpip2-deficient mice. Semin Immunopathol 37:407–12CrossRefPubMed
31.
go back to reference Smith EJ, Allantaz F, Bennett L, Zhang D, Gao X, Wood G et al (2010) Clinical, molecular, and genetic characteristics of PAPA syndrome: a review. Curr Genomics 11:519–27CrossRefPubMedPubMedCentral Smith EJ, Allantaz F, Bennett L, Zhang D, Gao X, Wood G et al (2010) Clinical, molecular, and genetic characteristics of PAPA syndrome: a review. Curr Genomics 11:519–27CrossRefPubMedPubMedCentral
32.
go back to reference Beck C, Girschick HJ, Morbach H, Schwarz T, Yimam T, Frenkel J et al (2011) Mutation screening of the IL-1 receptor antagonist gene in chronic non-bacterial osteomyelitis of childhood and adolescence. Clin Exp Rheumatol 29:1040–3PubMed Beck C, Girschick HJ, Morbach H, Schwarz T, Yimam T, Frenkel J et al (2011) Mutation screening of the IL-1 receptor antagonist gene in chronic non-bacterial osteomyelitis of childhood and adolescence. Clin Exp Rheumatol 29:1040–3PubMed
33.
go back to reference Morbach H, Dick A, Beck C, Stenzel M, Muller-Hermelink HK, Raab P et al (2010) Association of chronic non-bacterial osteomyelitis with Crohn’s disease but not with CARD15 gene variants. Rheumatol Int 30:617–21CrossRefPubMed Morbach H, Dick A, Beck C, Stenzel M, Muller-Hermelink HK, Raab P et al (2010) Association of chronic non-bacterial osteomyelitis with Crohn’s disease but not with CARD15 gene variants. Rheumatol Int 30:617–21CrossRefPubMed
34.
go back to reference Jansson AF, Grote V, Group ES (2011) Nonbacterial osteitis in children: data of a German incidence surveillance study. Acta Paediatr 100:1150–7CrossRef Jansson AF, Grote V, Group ES (2011) Nonbacterial osteitis in children: data of a German incidence surveillance study. Acta Paediatr 100:1150–7CrossRef
35.
go back to reference Golla A, Jansson A, Ramser J, Hellebrand H, Zahn R, Meitinger T et al (2002) Chronic recurrent multifocal osteomyelitis (CRMO): evidence for a susceptibility gene located on chromosome 18q21.3-18q22. Eur J Hum Genet 10:217–21CrossRefPubMed Golla A, Jansson A, Ramser J, Hellebrand H, Zahn R, Meitinger T et al (2002) Chronic recurrent multifocal osteomyelitis (CRMO): evidence for a susceptibility gene located on chromosome 18q21.3-18q22. Eur J Hum Genet 10:217–21CrossRefPubMed
36.
go back to reference Shin HD, Winkler C, Stephens JC, Bream J, Young H, Goedert JJ et al (2000) Genetic restriction of HIV-1 pathogenesis to AIDS by promoter alleles of IL10. Proc Natl Acad Sci U S A 97:14467–72CrossRefPubMedPubMedCentral Shin HD, Winkler C, Stephens JC, Bream J, Young H, Goedert JJ et al (2000) Genetic restriction of HIV-1 pathogenesis to AIDS by promoter alleles of IL10. Proc Natl Acad Sci U S A 97:14467–72CrossRefPubMedPubMedCentral
38.
go back to reference Xiao G, Cheng H, Cao H, Chen K, Tu Y, Yu S et al (2012) Critical role of filamin-binding LIM protein 1 (FBLP-1)/migfilin in regulation of bone remodeling. J Biol Chem 287:21450–60CrossRefPubMedPubMedCentral Xiao G, Cheng H, Cao H, Chen K, Tu Y, Yu S et al (2012) Critical role of filamin-binding LIM protein 1 (FBLP-1)/migfilin in regulation of bone remodeling. J Biol Chem 287:21450–60CrossRefPubMedPubMedCentral
39.
go back to reference Cox AJDBWLRM, Velez G, Bing X, Finer AL, Ervis A, Mahajan VB, Bassuk AG, Ferguson PJ (2017) Recessive Coding and Regulatory Mutations in FBLIM1 Underlie the Pathogenesis of Chronic Recurrent Multifocal Osteomyelitis (CRMO). PLoS One. in press. Cox AJDBWLRM, Velez G, Bing X, Finer AL, Ervis A, Mahajan VB, Bassuk AG, Ferguson PJ (2017) Recessive Coding and Regulatory Mutations in FBLIM1 Underlie the Pathogenesis of Chronic Recurrent Multifocal Osteomyelitis (CRMO). PLoS One. in press.
40.
go back to reference Schnabel AR U, Hahn G, Berner R, Hedrich CM (2017) Treatment response and long-term outcomes in children with chronic non-bacterial osteomyelitis (CNO). J Rheum. in press. Schnabel AR U, Hahn G, Berner R, Hedrich CM (2017) Treatment response and long-term outcomes in children with chronic non-bacterial osteomyelitis (CNO). J Rheum. in press.
41.
go back to reference Girschick HJ, Raab P, Surbaum S, Trusen A, Kirschner S, Schneider P et al (2005) Chronic non-bacterial osteomyelitis in children. Ann Rheum Dis 64:279–85CrossRefPubMedPubMedCentral Girschick HJ, Raab P, Surbaum S, Trusen A, Kirschner S, Schneider P et al (2005) Chronic non-bacterial osteomyelitis in children. Ann Rheum Dis 64:279–85CrossRefPubMedPubMedCentral
42.
go back to reference Schultz C, Holterhus PM, Seidel A, Jonas S, Barthel M, Kruse K et al (1999) Chronic recurrent multifocal osteomyelitis in children. Pediatr Infect Dis J 18:1008–13CrossRefPubMed Schultz C, Holterhus PM, Seidel A, Jonas S, Barthel M, Kruse K et al (1999) Chronic recurrent multifocal osteomyelitis in children. Pediatr Infect Dis J 18:1008–13CrossRefPubMed
43.
go back to reference Girschick HJ, Krauspe R, Tschammler A, Huppertz HI (1998) Chronic recurrent osteomyelitis with clavicular involvement in children: diagnostic value of different imaging techniques and therapy with non-steroidal anti-inflammatory drugs. Eur J Pediatr 157:28–33CrossRefPubMed Girschick HJ, Krauspe R, Tschammler A, Huppertz HI (1998) Chronic recurrent osteomyelitis with clavicular involvement in children: diagnostic value of different imaging techniques and therapy with non-steroidal anti-inflammatory drugs. Eur J Pediatr 157:28–33CrossRefPubMed
44.
go back to reference Job-Deslandre C, Krebs S, Kahan A (2001) Chronic recurrent multifocal osteomyelitis: five-year outcomes in 14 pediatric cases. Joint Bone Spine 68:245–51CrossRefPubMed Job-Deslandre C, Krebs S, Kahan A (2001) Chronic recurrent multifocal osteomyelitis: five-year outcomes in 14 pediatric cases. Joint Bone Spine 68:245–51CrossRefPubMed
45.
go back to reference Beck C, Morbach H, Beer M, Stenzel M, Tappe D, Gattenlohner S et al (2010) Chronic nonbacterial osteomyelitis in childhood: prospective follow-up during the first year of anti-inflammatory treatment. Arthritis Res Ther 12:R74CrossRefPubMedPubMedCentral Beck C, Morbach H, Beer M, Stenzel M, Tappe D, Gattenlohner S et al (2010) Chronic nonbacterial osteomyelitis in childhood: prospective follow-up during the first year of anti-inflammatory treatment. Arthritis Res Ther 12:R74CrossRefPubMedPubMedCentral
46.
go back to reference Daniels MJ, Rivers-Auty J, Schilling T, Spencer NG, Watremez W, Fasolino V et al (2016) Fenamate NSAIDs inhibit the NLRP3 inflammasome and protect against Alzheimer’s disease in rodent models. Nat Commun 7:12504CrossRefPubMedPubMedCentral Daniels MJ, Rivers-Auty J, Schilling T, Spencer NG, Watremez W, Fasolino V et al (2016) Fenamate NSAIDs inhibit the NLRP3 inflammasome and protect against Alzheimer’s disease in rodent models. Nat Commun 7:12504CrossRefPubMedPubMedCentral
47.
go back to reference Borzutzky A, Stern S, Reiff A, Zurakowski D, Steinberg EA, Dedeoglu F et al (2012) Pediatric chronic nonbacterial osteomyelitis. Pediatrics 130:e1190–e7CrossRefPubMed Borzutzky A, Stern S, Reiff A, Zurakowski D, Steinberg EA, Dedeoglu F et al (2012) Pediatric chronic nonbacterial osteomyelitis. Pediatrics 130:e1190–e7CrossRefPubMed
48.
go back to reference Carpenter E, Jackson MA, Friesen CA, Scarbrough M, Roberts CC (2004) Crohn’s-associated chronic recurrent multifocal osteomyelitis responsive to infliximab. J Pediatr 144:541–4CrossRefPubMed Carpenter E, Jackson MA, Friesen CA, Scarbrough M, Roberts CC (2004) Crohn’s-associated chronic recurrent multifocal osteomyelitis responsive to infliximab. J Pediatr 144:541–4CrossRefPubMed
49.
go back to reference Twilt M, Laxer RM (2011) Clinical care of children with sterile bone inflammation. Curr Opin Rheumatol 23:424–31CrossRefPubMed Twilt M, Laxer RM (2011) Clinical care of children with sterile bone inflammation. Curr Opin Rheumatol 23:424–31CrossRefPubMed
50.
go back to reference Hospach T, Langendoerfer M, von KT, Maier J, Dannecker GE (2010) Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate. Eur J Pediatr 169:1105–11CrossRefPubMed Hospach T, Langendoerfer M, von KT, Maier J, Dannecker GE (2010) Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate. Eur J Pediatr 169:1105–11CrossRefPubMed
51.
go back to reference Tlougan BE, Podjasek JO, O’Haver J, Cordova KB, Nguyen XH, Tee R et al (2009) Chronic recurrent multifocal osteomyelitis (CRMO) and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome with associated neutrophilic dermatoses: a report of seven cases and review of the literature. Pediatr Dermatol 26:497–505CrossRefPubMed Tlougan BE, Podjasek JO, O’Haver J, Cordova KB, Nguyen XH, Tee R et al (2009) Chronic recurrent multifocal osteomyelitis (CRMO) and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome with associated neutrophilic dermatoses: a report of seven cases and review of the literature. Pediatr Dermatol 26:497–505CrossRefPubMed
52.
go back to reference Miettunen PM, Wei X, Kaura D, Reslan WA, Aguirre AN, Kellner JD (2009) Dramatic pain relief and resolution of bone inflammation following pamidronate in 9 pediatric patients with persistent chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J 7:2CrossRefPubMedPubMedCentral Miettunen PM, Wei X, Kaura D, Reslan WA, Aguirre AN, Kellner JD (2009) Dramatic pain relief and resolution of bone inflammation following pamidronate in 9 pediatric patients with persistent chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J 7:2CrossRefPubMedPubMedCentral
Metadata
Title
The molecular pathophysiology of chronic non-bacterial osteomyelitis (CNO)—a systematic review
Authors
Sigrun Ruth Hofmann
Franz Kapplusch
Katrin Mäbert
Christian Michael Hedrich
Publication date
01-12-2017
Publisher
Springer Berlin Heidelberg
Published in
Molecular and Cellular Pediatrics / Issue 1/2017
Electronic ISSN: 2194-7791
DOI
https://doi.org/10.1186/s40348-017-0073-y

Keynote webinar | Spotlight on adolescent vaping

  • Live
  • Webinar | 29-01-2025 | 18:00 (CET)

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Watch it live: Wednesday 29th January, 18:00-19:30 CET
 

Prof. Ann McNeill
Dr. Debbie Robson
Benji Horwell
Developed by: Springer Medicine
Join the webinar