Case report on chronic non-bacterial osteomyelitis (CNO) and review of literature

Abstract

Introduction: Chronic Non-Bacterial Osteomyelitis (CNO) is a rare inflammatory disorder not related to any infectious disease 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.Case Report: A case of 6 year old female which presented with non-specific bone pain in the metadiaphyseal region of proximal humerus. X-rays had osteolytic lesions in the metadiaphyseal region and with a history of trivial trauma and no positive history of autoimmunity. Conclusion: CNO is difficult to identify and no consensus exist on diagnosis and treatment modality. Multifocal bone lesions with characteristic radiological findings are very suggestive of CNO. But dilemma with unifocal lesion with no corroborative findings. In such cases diagnosis is achieved with exclusion. No data exist on best treatment option after Non-Steroidal Anti-Inflammatory Drugs failure. But excision biopsy with complete curettage in unifocal lesions gives immediate symptom relief and long term good outcome without a background of identifiable auto-immune disease.