[Clinical analysis of chronic nonbacterial osteomyelitis involving the mandible in 35 adolescents].

PURPOSE: To summarize and analyze the clinicopathological features of chronic nonbacterial osteomyelitis (CNO) in adolescents, and to provide opinions for better diagnosis and treatment of the disease.

METHODS

A retrospective study was conducted on adolescent patients diagnosed with CNO in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from September 2013 to December 2023. The demographic data, laboratory examination, imaging examination, pathological manifestations and treatment results of the patients were summarized. Clinical symptom evaluations, laboratory tests and imaging examinations were used to evaluate the effect of clinical treatment.

RESULTS

Thirty-five patients were included, including 14 males and 21 females, with a male to female ratio of 1∶1.5. 45.7% patients had multiple lesions. Diagnoses prior to diagnosis of CNO included fibrous dysplasia, parotitis, infectious osteomyelitis and idiopathic arthritis. Abnormal increases in laboratory test indicators included white blood cells (20%), erythrocyte sedimentation rate (60%), C-reactive protein (40%), interleukin-6 (22.9%) and so on. CT findings showed osteolytic, sclerosing and hyperostosis. Bone scans showed multiple lesions in 5 patients. In drug therapy, the effective rate of NSAIDs and DMARDs exceeded 50%.

CONCLUSIONS

Interleukin-6 is elevated in some CNO patients, and its relationship with pathogenesis needs to be further studied. The recurrence rate of decortication is high, and drug therapy may be more effective than surgical treatment.