Chronic non-bacterial osteomyelitis of distal ulna in a paediatric patient: a case report and review of literature

Authors

  • Neetin P. Mahajan Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India
  • Sunny M. Sangma Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India http://orcid.org/0000-0001-7108-393X
  • Ashish Kumar Jarika Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India
  • Jayesh Anant Mhatre Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20221136

Keywords:

Chronic non-bacterial osteomyelitis, Chronic recurrent multifocal osteomyelitis, Metaphysis of long bones, Paediatric age group

Abstract

Chronic non-bacterial osteomyelitis (CNO) is a rare disorder characterized by focal aseptic inflammation with a self-limiting, relapsing course of disease with female predominance and usually observed in paediatric age groups diagnosed by clinical, radiological and histopathological findings after ruling out all other differentials. We reported this rare case found in a 7 year old female with a history of greenstick fracture of distal ulna 3 years ago with flaring up of pain and swelling since trivial trauma to left wrist 1 month ago. We emphasize on the relevant data and findings to reach the conclusive diagnosis and treatment of the disease. CNO can present as benign unifocal non-relapsing to more severe form of multifocal relapsing inflammatory lesions involving metaphysis of long bones, vertebrae, clavicle and mandible. Diagnosis is made after excluding infection, malignancy, auto-immune and metabolic disorders. Treatment is mainly empirical to reduce pain and inflammation through NSAIDs, corticosteroids, bisphosphonates and sometimes TNF alpha inhibitors as no proper guidelines are available.

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Author Biographies

Neetin P. Mahajan, Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India

       Professor and unit head

       Dept of orthopaedics

       Grant govt medical college ,Mumbai.

Sunny M. Sangma, Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India

       Junior resident

       Dept. of orthopaedics

       Grant govt medical college ,Mumbai.

 

Ashish Kumar Jarika, Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India

       Junior resident

       Dept. of orthopaedics

       Grant govt medical college ,Mumbai.

 

Jayesh Anant Mhatre, Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India

       Junior resident

       Dept. of orthopaedics

       Grant govt medical college ,Mumbai.

 

References

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Björkstén B, Gustavson KH, Eriksson B, Lindholm A, Nordström S. Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris. J Pediatr. 1978;93(2):227-31.

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Schnabel A, Range U, Hahn G, Berner R, Hedrich CM. Treatment response and longterm outcomes in children with chronic nonbacterial osteomyelitis. J Rheumatol. 2017;44:1058-65.

Hedrich CM, Hahn G, Girschick HJ, Morbach H. A clinical and pathomechanistic profile of chronic nonbacterial osteomyelitis/chronic recurrent multifocal osteomyelitis and challenges facing the field. Expert Rev Clin Immunol. 2013;9:845-54.

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Published

2022-04-25

How to Cite

Mahajan, N. P., Sangma, S. M., Jarika, A. K., & Mhatre, J. A. (2022). Chronic non-bacterial osteomyelitis of distal ulna in a paediatric patient: a case report and review of literature. International Journal of Research in Orthopaedics, 8(3), 411–414. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20221136

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Section

Case Reports