Koru Lutfiye, Baysal Begumhan, Yıldırım Ayse Nur Toksoz, Dizman Eda Nur, Dursun Hatice Kubra, Balci Merve Ozen, Kucuk Elif, Kaya Feray, Aydin Zelal, Haslak Fatih, Ozturk Kubra
Department of Pediatric Rheumatology, Istanbul Medeniyet University, Istanbul, Turkey.
Department of Radiology, Istanbul Medeniyet University, Istanbul, Turkey.
Rheumatol Int. 2025 Jan 3;45(1):16. doi: 10.1007/s00296-024-05768-1.
Chronic non-bacterial osteomyelitis (CNO) is an inflammatory bone disease, usually diagnosed in childhood. It is characterized by the presence of multifocal or unifocal osteolytic lesions that can cause bone pain and soft tissue swelling. CNO is known to have soft tissue involvement. However, soft tissue involvement large enough to give the appearance of a mass is rare. This article discusses a case of CNO with a mass-like appearance that involved soft tissue and spontaneously regressed, as well as presents CNO cases with soft tissue involvement and conducts a literature review on this subject. Our investigation revealed that edema and synovitis were the most frequently observed soft tissue involvements in association with CNO. Moreover, we also encountered myositis, a mass-like appearance, neuritis, and polyserositis within the surrounding muscles. Although, it is well known that bone inflammation tends to regress spontaneously in CNO patients which reflects the autoinflammatory nature of the disease, there is no such patient whose soft tissue involvement which has mass like appearance improved spontaneously. Therefore, we aimed to emphasize the clinical progress which can be easily underdiagnosed of CNO patients by the clinicians by presenting unique features of our patient and our detailed literature review.
慢性非细菌性骨髓炎（CNO）是一种炎症性骨病，通常在儿童期被诊断出来。其特征是存在多灶性或单灶性溶骨性病变，可导致骨痛和软组织肿胀。已知CNO会累及软组织。然而，软组织受累范围大到足以形成肿块的情况很少见。本文讨论了一例表现为肿块样外观且累及软组织并自发消退的CNO病例，同时展示了伴有软组织受累的CNO病例，并对该主题进行了文献综述。我们的调查显示，水肿和滑膜炎是与CNO相关的最常见的软组织受累情况。此外，我们还在周围肌肉中发现了肌炎、肿块样外观、神经炎和多浆膜炎。尽管众所周知，CNO患者的骨炎症往往会自发消退，这反映了该疾病的自身炎症性质，但尚无软组织受累呈现肿块样外观的患者自发好转的情况。因此，我们旨在通过展示我们患者的独特特征和详细的文献综述，强调临床医生可能容易漏诊的CNO患者的临床进展情况。
