Urinary N-telopeptide as a Biomarker of Disease Activity in Patients with Chronic Nonbacterial Osteomyelitis Who Have Not Received Bisphosphonates

Perkins, Andrew; Stevens, Anne M.; Ferguson, Polly J.; Zhao, Yong

doi:10.3899/jrheum.191098

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…We have employed CT more than MRI, but have attempted to limit CT examinations 6 months apart. On the other hand, based on bone inflammation in CNO, which is associated with increased osteoclastic activity and bone resorption, causing the focal accelerated breakdown of bone collagen, assay of urinary N-terminal telopeptide (NTx) could be helpful as an important biological marker [ 20 , 21 ]. In our patient’s follow-up, we have begun testing the usefulness of urinary NTx assay.…”

Section: Discussionmentioning

confidence: 99%

Chronic Nonbacterial Osteomyelitis of the Jaw in a 3-Year-Old Girl

Makino¹,

Oshige²,

Shinozuka³

et al. 2023

Pediatric Reports

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Differential diagnosis of bacterial osteomyelitis (BOM) and chronic nonbacterial osteomyelitis (CNO) is challenging. Pediatric CNO can be diagnosed at around 10 years of age and when CNO cases involve only the jaw, it is difficult to make a diagnosis in a young child. A 3-year-old female developed CNO at the jaw alone. She presented with no fever, right jaw pain, mild trismus, and a preauricular facial swelling around the right mandible. Computed tomography (CT) revealed a hyperostotic right mandible, with osteolytic and sclerotic changes associated with periosteal reaction. At first, we suspected BOM and antibiotics were administered. Subsequently, CNO was diagnosed, and the patient received flurbiprofen (a nonsteroidal anti-inflammatory drug (NSAIDs)). Lack of a sufficient response led to successful treatment with a combination of oral alendronate and flurbiprofen. Physicians should be aware of CNO, a rare autoinflammatory noninfectious bone disease of unknown etiology, even in young children, although the disease mostly affects older children and adolescents.

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Section: Discussionmentioning

confidence: 99%

Chronic Nonbacterial Osteomyelitis of the Jaw in a 3-Year-Old Girl

Makino¹,

Oshige²,

Shinozuka³

et al. 2023

Pediatric Reports

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Chronic Recurrent Multifocal Osteomyelitis (Chronic Non-infective Osteitis)

Murray

Sen

Ramanan

2022

Pediatric Musculoskeletal Infections

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Chronic Nonbacterial Osteomyelitis

Nuruzzaman¹,

Zhao²,

Ferguson³

2021

Rheumatic Disease Clinics of North America

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To review the neuroimaging of a series of infants and young children admitted to hospital with subdural haemorrhage (SDH). Methods: Neuroradiological investigations of 74 children under 2 years of age, from South Wales and southwest England, in whom an SDH or subdural effusion had been diagnosed between 1992 and 2001, were reviewed. Two paediatric neuroradiologists blinded to the original radiological report reviewed all the relevant images. Results: Neuroradiological review of images identified radiological features which were highly suggestive of non-accidental head injury (NAHI). Interhemispheric haemorrhages and SDHs in multiple sites or of different densities were almost exclusively seen in NAHI. MRI was more sensitive in identifying SDHs of different signal characteristics, posterior and middle cranial fossa bleeds, and parenchymal changes in the brain. CT scans, if performed with suboptimal protocols, were likely to miss small subdural bleeds. Conclusions: Guidelines for neuroimaging in suspected NAHI are recommended. A radiologist with experience in NAHI should report or review these scans. The initial investigation should be CT, but MRI will also be necessary in most cases. Head CT should be an integral part of the skeletal survey in all infants less than 6 months of age referred for child protection investigation, and in children less than 2 years where child abuse is suspected and there are neurological signs, retinal haemorrhages, or fractures.

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Urinary N-telopeptide as a Biomarker of Disease Activity in Patients with Chronic Nonbacterial Osteomyelitis Who Have Not Received Bisphosphonates

Cited by 3 publications

References 8 publications

Chronic Nonbacterial Osteomyelitis of the Jaw in a 3-Year-Old Girl

Chronic Nonbacterial Osteomyelitis of the Jaw in a 3-Year-Old Girl

Chronic Recurrent Multifocal Osteomyelitis (Chronic Non-infective Osteitis)

Chronic Nonbacterial Osteomyelitis

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