Physicians’ Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis

Yongdong Zhao; Fatma Dedeoglu; Polly J Ferguson; Sivia K Lapidus; Ronald M Laxer; Miranda C Bradford; Suzanne C Li

doi:10.1155/2017/7694942

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Physicians’ Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis

Journal article

Open access

Peer reviewed

Physicians’ Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis

Yongdong Zhao, Fatma Dedeoglu, Polly J Ferguson, Sivia K Lapidus, Ronald M Laxer, Miranda C Bradford and Suzanne C Li

International journal of rheumatology, Vol.2017, pp.1-7

2017

DOI: 10.1155/2017/7694942

PMCID: PMC5259599

PMID: 28167963

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Abstract

Background/Purpose. Understanding the practices of pediatric rheumatologists in diagnosing and treating chronic nonbacterial osteomyelitis (CNO) can provide important information to guide the development of consensus treatment plans. The objectives of this study were to determine physicians’ approaches to (1) diagnosing and monitoring CNO, (2) ordering a bone biopsy, and (3) making treatment decisions. Methods. A survey was distributed among members of the Childhood Arthritis and Rheumatology Research Alliance using a web-based questionnaire. Results. 121 of 277 (41%) attending physician members completed the survey. Plain radiographs (89%) were most commonly used followed by regional MRI (78%), bone scintigraphy (43%), and whole-body MRI (36%). The top three reasons for performing a biopsy were constitutional findings (66%), unifocal bone lesions (64%), and nocturnal bone pain (45%). Nearly all responders (95%) prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) as initial therapy. For patients who failed NSAID treatment, methotrexate (67%), tumor necrosis factor inhibitors (65%), and bisphosphonates (46%) were the next most commonly used treatments. The presence of a spinal lesion increased the use of bisphosphonate treatment. Conclusion. The diagnostic approach and disease activity monitoring for CNO varied among surveyed physicians. Our survey findings provided important background for the development of consensus treatment plans for CNO.

Details

Title: Subtitle: Physicians’ Perspectives on the Diagnosis and Treatment of Chronic Nonbacterial Osteomyelitis
Creators: Yongdong Zhao - Pediatric Rheumatology, Seattle Children’s Hospital, Seattle, WA, USA
Fatma Dedeoglu - Rheumatology, Boston Children’s Hospital, Boston, MA, USA
Polly J Ferguson - Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA
Sivia K Lapidus - Pediatric Rheumatology, Goryeb Children’s Hospital, Morristown, NJ, USA
Ronald M Laxer - Division of Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada
Miranda C Bradford - Center for Clinical and Translational Research, Seattle Children’s Hospital, Seattle, WA, USA
Suzanne C Li - Pediatrics, Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center, Hackensack, NJ, USA
Resource Type: Journal article
Publication Details: International journal of rheumatology, Vol.2017, pp.1-7
DOI: 10.1155/2017/7694942
PMID: 28167963
PMCID: PMC5259599
NLM abbreviation: Int J Rheumatol
ISSN: 1687-9260
eISSN: 1687-9279
Grant note: DOI: 10.13039/100006108, name: Center of Clinical and Translational Research in Seattle Children’s Hospital, award: TR000002, RR025014
Language: English
Date published: 2017
Academic Unit: Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Rheumatology, Allergy, and Immunology
Record Identifier: 9984070219602771

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