Researchers and doctors are beginning to recognize the rare autoinflammatory bone disease known as chronic nonbacterial osteomyelitis (CNO). To raise awareness of certain demographics, traits, and presentations of this uncommon condition, investigators for a study intended to publish data from the cohort of CNO patients residing in the northwest United States.

The computerized medical records underwent a retrospective chart review. From 2005 to 2019, patients with complete clinic records who matched the CNO diagnosis criteria were included. The findings of a bone biopsy, patient demographics, and the locations of lesions on advanced imaging were all examined in the extracted data. The yearly new case rate at the facility was calculated using King County census data.

In all, 215 instances of CNO were identified at the sizable tertiary pediatric hospital. White people who lived in King County, Washington’s most populated county, made up most of the cases. Although there didn’t seem to be a seasonal preference, most cases were identified between 2016 and 2019, suggesting a considerable rise in the yearly incidence rate in King County from 8 to 23 per million kids. Only 52% against 75% of samples were biopsied. About 152 (71%) of the kids had a history of autoimmune disease. The results of more frequently used whole-body magnetic resonance imaging (WB-MRI) revealed that 68% of patients had multiple lesions.

Diagnoses of CNO have been more frequent in recent years. Other lesions that could be asymptomatic at presentation may be easier to find with WB-MRI. Some children still need a bone biopsy when they are diagnosed.

Reference: jrheum.org/content/49/8/929