Chronic Nonbacterial Osteomyelitis/Chronic Recurrent Multifocal Osteomyelitis (CNO/CRMO)
How to pronounce it:
Osteomyelitis -
os-tee-oh-mEYE-uh-lai-tis
AiArthritis defines CNO/CRMO as:
CNO/CRMO is a rare autoinflammatory disease where the bones become inflamed without infection. It causes long-term bone pain and swelling, often affecting the long bones, pelvis, shoulder, and spine. The disease mostly occurs in children.
Symptoms & Characteristics
Common in All AiArthritis Diseases
Flares: Periods of worsening symptoms are called flares. A flare can last for hours, days, weeks, or months.
Physical Activity: Condition improves with activity and exercise and worsens with rest.
Comorbidities: When inflammation is left uncontrolled due to lack of proper treatment, comorbidities can develop. 70% of patients with chronic, lifelong disease will develop comorbidities, including dual or triple diagnoses.
Family History:
Autoimmune diseases often run in families, indicating a potential genetic predisposition where that gene can cause disease. Autoinflammatory diseases can occur multiple times in a family, but is based off of genetic mutation. It is not a gene that causes the disease— but a mutation on the gene that can cause the disease which can then be passed on to the next generation.
"Auto" Symptoms
Fatiga: Fatiga o agotamiento severo que puede no aliviarse con cafeína o estimulantes y que puede presentarse incluso después de un largo período de descanso.
Disfunción cognitiva: Niebla mental o periodos de tiempo en los que el pensamiento se nubla y resulta difícil concentrarse.
Síntomas similares a los de la gripe: Sin tener gripe: náuseas, debilidad muscular y malestar general.
Fiebre: Por lo general, el grado es bajo en las enfermedades autoinmunes (con excepción de la artritis idiopática juvenil) y el grado es más alto en las autoinflamatorias (el porcentaje varía mucho según la enfermedad).
Referencia: Estudio sobre los primeros síntomas de la artritis inducida por adyuvante, AiArthritis, 2019.
Inflammatory Arthritis Symptoms
Stiffness: Severe stiffness in one or more joints, especially in the morning or after sitting for long periods of time.
Joint Pain: Episodes of joint pain that may last for hours, days, or even weeks, that can appear and disappear suddenly. Often described as “jumping pain” into different locations.
Typically the joint pain will coincide with one or more “Auto” symptoms and start and stop suddenly - for no apparent reason (which is called a "flare"). Some people will experience all of the above symptoms, others only a few.
If you have any of the arthritis features, and at least one of the “Auto” features, please consult your physician about a referral to a specialist.
Symptoms Often Associated with CNO/CRMO
- Fluid buildup around painful areas
- Swollen, warm skin over painful bones
- Thicker joint linings
- Damage to cartilage
- Sometimes linked with skin conditions like psoriasis or Crohn’s disease
Diagnóstico de osteomielitis crónica no bacteriana/osteomielitis multifocal recurrente crónica (OCN/OMRC)
There’s no single test that can confirm a diagnosis of Chronic Nonbacterial Osteomyelitis (CNO) or Chronic Recurrent Multifocal Osteomyelitis (CRMO), so rheumatologists rely on a combination of symptoms, imaging, and medical history, while ruling out infection or cancer.
Buscan dolor óseo persistente o recurrente, a veces en varias zonas, junto con hinchazón o sensibilidad. Los síntomas pueden aparecer y desaparecer (brotes), y los médicos también consideran los síntomas comunes de la artritis autoinmune para descartar otras afecciones.
Imaging—especially MRI—is a key part of diagnosis. It can show inflammation in the bone and identify lesions, even in areas without symptoms. Whole-body MRI may be used to detect multiple affected sites.
Blood tests are used to support diagnosis and rule out other conditions. Typical findings may include:
- mild inflammation (elevated ESR or CRP)
- normal or slightly abnormal lab results
- no signs of infection (negative cultures)
These results help rule out infection or other diseases but are not specific to CNO/CRMO.
In some cases, doctors may perform a bone biopsy to confirm there is no infection or cancer. Doctors may also use clinical criteria (such as Bristol or Jansson) to support their diagnosis.
Opciones de tratamiento para la osteomielitis crónica no bacteriana/osteomielitis multifocal recurrente crónica (OCN/OMRC):
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Chronic Nonbacterial Osteomyelitis (CNO) and Chronic Recurrent Multifocal Osteomyelitis (CRMO) were first described in the 1970s when doctors observed recurring bone inflammation in children without bacterial infection, which is typical for osteomyelitis. The term “osteomyelitis” refers to bone inflammation, but “nonbacterial” indicates that no infection is involved. CRMO highlights the recurrent and multifocal nature of the disease, where multiple areas of the bone are affected and symptoms flare and resolve over time. Over the years, CNO has become the broader term to describe the spectrum of nonbacterial bone inflammation, while CRMO refers specifically to its chronic, recurrent form.
- World Autoimmune and Autoinflammatory Arthritis Day - May 20th
- Rare Disease Day - February 29th (28th)
- Autoimmune Awareness Month - March
- Rheumatic Disease Awareness Month - September
- Pain Awareness Month - September
- Chronic Disease Awareness Day - July 10th
- Invisible Disabilities Week - 3rd full week of October
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Última actualización de la página: 31/10/2024