Arthritis und Rheuma 2006; 26(06): 347-354
DOI: 10.1055/s-0037-1620084
Kinderrheumatologie
Schattauer GmbH

Frühdiagnose nicht-bakterieller Osteitiden

Early diagnosis of non-bacterial osteitis
Annette Jansson
1   Kinderklinik und Kinderpoliklinik der LMU Dr. von Haunersches Kinderspital, München
› Author Affiliations
Further Information

Publication History

Publication Date:
23 December 2017 (online)

Zusammenfassung

Die nicht-bakterielle Osteitis (NBO) ist eine Autoinflammationserkrankung ungeklärter Pathogenese. Sie stellt eine wichtige Differenzialdiagnose der bakteriellen Osteomyelitis dar und wird dem rheumatischen Formenkreis zugeordnet. Sie kann sich in jedem Lebensalter manifestieren und einen akuten oder einen chronischen Verlauf nehmen. Eine frühzeitige Diagnosestellung bewahrt den Patienten vor langwierigen antibiotischen Behandlungen und invasiven Eingriffen. Therapie der Wahl sind nichtsteroidale Antiphlogistika.

Summary

Non-bacterial osteitis (NBO) is an auto inflammatory disease with unknown origin and pathogenesis and should be considered as an important differential diagnosis of bacterial osteomyelitis. NBO is thought to belong to rheumatic disorders and can occur at any age. Its clinical course can be acute or chronic. Early diagnosis prevents patients from long lasting antibiotic therapies and invasive procedures. NSAIDs are the treatment of choice.

 
  • Literatur

  • 1 Beretta-Piccoli BC.. et al. Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome in childhood: a report of ten cases and review of the literature. Eur J Pediatr 2000; 159 (08) 594-601.
  • 2 Deutschmann A.. et al. Successful treatment of chronic recurrent multifocal osteomyelitis with tumor necrosis factor-alpha blockage. Pediatrics 2005; Nov 116 (05) 1231-3.
  • 3 Dihlmann W.. et al. The acquired hyperostosis syndrome. Synthesis of 13 personal observations of sternocostoclavicular hyperostosis and 300 cases from the literature. 1. Rofo 1988; 149 (04) 386-91.
  • 4 Dihlmann W.. Acquired hyperostosis syndrome (so-called pustular arthro-osteitis). Review of the literature including 73 personal cases. Wien Klin Wochenschr 1993; 105 (05) 127-38.
  • 5 Earwaker JW.. et al. SAPHO: syndrome or concept? Imaging findings. Skeletal Radiol 2003; 32 (06) 311-27.
  • 6 Ferguson PJ.. et al. A missense mutation in pstpip 2 is associated with the murine autoinflammatory disorder chronic multifocal osteomyelitis. Bone 2006; 38: 41-7. E-Pub 24 August 2005
  • 7 Freyschmidt J.. et Al. The bullhead sign: scintigraphic pattern of sternocostoclavicular hyperostosis and pustulotic arthroosteitis. Eur Radiol 1998; 8 (05) 807-12.
  • 8 Girschick HJ.. et al. Chronic non-bacterial osteomyelitis in children. Ann Rheum Dis 2005; 64 (02) 279-85.
  • 9 Golla A.. et al. Chronic recurrent multifocal osteomyelitis (CRMO): evidence for a susceptibility gene located on chromosome 18q21.3–18q22. Eur J Hum Genet 2002; 10 (03) 217-21.
  • 10 Hayem G.. et al. SAPHO syndrome: a long-term follow-up study of 120 cases. Semin Arthritis Rheum 1999; 29 (03) 159-71.
  • 11 Huber AM.. et al. Chronic recurrent multifocal osteomyelitis: clinical outcomes after more than five years of follow-up. J Pediatr 2002; 141 (02) 198-203.
  • 12 Jansson A.. et al. Die chronisch rezidivierende multifokale Osteomyelitis (CRMO). Übersicht und erste Befunde einer genetisch-rheumatologischen Studie. Monatsschr Kinderheilkd 2002; 150: 477-89.
  • 13 Jansson A.. et al. Chronisch rezidivierende multifokale Osteomyelitis und andere nichtbakterielle Osteitiden. Deutsches Ärzteblatt 101 (09) A584-9.
  • 14 Jansson A., Borte M., Böschow G.. et al. Nicht-Bakterielle Osteitis des Kindes - und Erwachsenenalters. Konsensus-Statement des 8. Wörlitzer Expertengespräches 2005 für die Deutsche Gesellschaft für Kinder- und Jugendrheumatologie. Monatsschr Kinderheilkd 2006; 154 (08) 331-4.
  • 15 Jansson A., Renner ED., Ramser J.. et al. Classification of Non-Bacterial Osteitis: Retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatology. DOI: 10.1093/rheumatology/Publ. online 17.6.06..
  • 16 Kerrison C.. et al. Pamidronate in the treatment of childhood SAPHO syndrome. Rheumatology (Oxford) 2004; Oct 43 (10) 1246-51. Epub 2004 Jul 6.
  • 17 Pijning JM.. et al. Tietze&quote;s syndrome in a 2-year old boy. Ned Tijdschr Geneeskd 2003; Oct 25 147 (43) 2134-6.
  • 18 Reinehr T.. et al. Chronic osteomyelitis in childhood: is surgery always indicated?. Infection 2000; Sep 28 (05) 282-6.
  • 19 Reuland P.. et al. Differential diagnosis of childhood osteomyelitis-classification according to scintigraphic, radiologic and magnetic resonance tomographic characteristics. Nuklearmedizin 1996; Jun 35 (03) 68-77.
  • 20 Schilling F.. et al. Chronic recurrent multifocal osteomyelitis in association with chronic inflammatory bowel disease: entheropathic CRMO. Z Rheumatol 2003; 62 (06) 527-38.
  • 21 Schilling F.. et al. SAPHO syndrome: clinico-rheumatologic and radiologic differentiation and classification of a patient sample of 86 cases. Z Rheumatol 2000; Feb 59 (01) 1-28.
  • 22 Sugimoto H.. et al. The SAPHO syndrome: defining the radiologic spectrum of diseases comprising the syndrome. Eur Radiol 1998; 8 (05) 800-6.
  • 23 Vienne P.. et al. Garre sclerosing osteomyelitis. Orthopäde 1997; Oct 26 (10) 902-7.