{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:13:17Z","timestamp":1777633997395,"version":"3.51.4"},"reference-count":93,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic Non-bacterial Osteomyelitis (CNO) is a rare autoinflammatory bone disease primarily affecting children and adolescents. The disease presents with a wide spectrum of severity, ranging from mild unifocal lesions to severe, recurrent multifocal bone inflammation. Its etiology remains unclear, making diagnosis challenging due to nonspecific symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report the case of a 14-year-old girl who presented with recurrent swelling and pain in the left clavicle. After multiple admissions, the patient underwent extensive diagnostic workup, including laboratory tests, imaging, and biopsies, which showcased typical imaging and histopathological findings throughout the disease progression, helping to rule out infections and malignancies. Based on clinical findings and the exclusion of other conditions, she was diagnosed with CNO. Treatment included NSAIDs, intravenous antibiotics, and oral medications such as diclofenac sodium, naproxen, methotrexate, and calcitriol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the one-year follow-up after initial treatment, the patient experienced recurrent symptoms, including swelling and pain in the left clavicle. After escalation to intravenous pamidronate and subcutaneous adalimumab, the patient achieved sustained clinical remission. During the subsequent two-year follow-up, no further symptom recurrence was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CNO is generally diagnosed by exclusion, with MRI being the gold standard for detecting asymptomatic lesions and assessing disease activity. Treatment typically involves NSAIDs, with bisphosphonates and biologics increasingly used in refractory cases. This case underscores the complexity of diagnosing and managing CNO, highlighting the need for a multidisciplinary approach. Further research is essential to establish standardized diagnostic criteria and optimize treatment strategies for this rare condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1747342","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T06:50:36Z","timestamp":1772175036000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Chronic nonbacterial osteomyelitis: a typical case and review"],"prefix":"10.3389","volume":"14","author":[{"given":"Qiang","family":"Li","sequence":"first","affiliation":[{"name":"Departmet of Orthopaedic Surgery, Children\u2019s Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Departmet of Orthopaedic Surgery, Children\u2019s Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Liu","sequence":"additional","affiliation":[{"name":"Departmet of Orthopaedic Surgery, Children\u2019s Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pengfei","family":"Zheng","sequence":"additional","affiliation":[{"name":"Departmet of Orthopaedic Surgery, Children\u2019s Hospital of Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1080\/15513815.2021.1978602","article-title":"Chronic recurrent multifocal osteomyelitis (CRMO): a study of 12 cases from one institution and literature review","volume":"41","author":"Chang","year":"2022","journal-title":"Fetal Pediatr Pathol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s12969-022-00698-3","article-title":"Chronic nonbacterial osteomyelitis in children: a multicentre Belgian cohort of 30 children","volume":"20","author":"Kaut","year":"2022","journal-title":"Pediatr Rheumatol Online J"},{"key":"B3","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.bjoms.2023.12.022","article-title":"Collaborative approach to paediatric chronic non-bacterial osteomyelitis of the mandible: great ormond street hospital case series","volume":"62","author":"Mohamedbhai","year":"2024","journal-title":"Br J Oral Maxillofac Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"419","DOI":"10.46497\/ArchRheumatol.2021.8137","article-title":"Clinical features of children with chronic non-bacterial osteomyelitis: a multicenter retrospective case series from Turkey","volume":"36","author":"Acari","year":"2021","journal-title":"Arch Rheumatol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2162","DOI":"10.1093\/rheumatology\/keae447","article-title":"Incidence of chronic recurrent multifocal osteomyelitis in children and adolescents in the UK and republic of Ireland","volume":"64","author":"Chia","year":"2025","journal-title":"Rheumatology (Oxford)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"929","DOI":"10.3899\/jrheum.210991","article-title":"Increasing cases of chronic nonbacterial osteomyelitis in children: a series of 215 cases from a single tertiary referral center","volume":"49","author":"Aden","year":"2022","journal-title":"J Rheumatol"},{"key":"B7","first-page":"329","article-title":"Subacute and chronic \u201csymmetrical\u201d osteomyelitis","volume":"15","author":"Giedion","year":"1972","journal-title":"Ann Radiol (Paris)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1007\/s11926-012-0239-5","article-title":"Current understanding of the pathogenesis and management of chronic recurrent multifocal osteomyelitis","volume":"14","author":"Ferguson","year":"2012","journal-title":"Curr Rheumatol Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1136\/ard.2004.023838","article-title":"Chronic non-bacterial osteomyelitis in children","volume":"64","author":"Girschick","year":"2005","journal-title":"Ann Rheum Dis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"860646","DOI":"10.3389\/fimmu.2022.860646","article-title":"Clinical and genetic features of Chinese adult patients with chronic non-bacterial osteomyelitis: a single center report","volume":"13","author":"Zhao","year":"2022","journal-title":"Front Immunol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1002\/jmri.27299","article-title":"The many faces of pediatric chronic recurrent multifocal osteomyelitis (CRMO): a practical location- and case-based approach to differentiate CRMO from its mimics","volume":"54","author":"Menashe","year":"2021","journal-title":"J Magn Reson Imaging"},{"key":"B12","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1007\/s11914-017-0405-9","article-title":"Chronic recurrent multifocal osteomyelitis (CRMO): presentation, pathogenesis, and treatment","volume":"15","author":"Hofmann","year":"2017","journal-title":"Curr Osteoporos Rep"},{"key":"B13","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s12969-019-0340-7","article-title":"Efficacy of pamidronate in children with chronic non-bacterial osteitis using whole body MRI as a marker of disease activity","volume":"17","author":"Bhat","year":"2019","journal-title":"Pediatr Rheumatol Online J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"109344","DOI":"10.1016\/j.clim.2023.109344","article-title":"Gathering expert consensus to inform a proposed trial in chronic nonbacterial osteomyelitis (CNO)","volume":"251","author":"Hedrich","year":"2023","journal-title":"Clin Immunol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1007\/s00296-021-04886-4","article-title":"Patient-reported effectiveness and safety of pamidronate in NSAIDs-refractory chronic recurrent multifocal osteomyelitis in children","volume":"42","author":"Juszczak","year":"2022","journal-title":"Rheumatol Int"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3390\/ph15111365","article-title":"A review of the safety of interleukin-17A inhibitor secukinumab","volume":"15","author":"Eshwar","year":"2022","journal-title":"Pharmaceuticals (Basel)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1093\/jbmr\/zjae141","article-title":"An improved understanding of pediatric chronic nonbacterial osteomyelitis pathophysiology informs current and future treatment","volume":"39","author":"Roberts","year":"2024","journal-title":"J Bone Miner Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1093\/rheumatology\/kel190","article-title":"Classification of non-bacterial osteitis: retrospective study of clinical, immunological and genetic aspects in 89 patients","volume":"46","author":"Jansson","year":"2007","journal-title":"Rheumatology (Oxford)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"107452","DOI":"10.1016\/j.pharmthera.2019.107452","article-title":"Anti-inflammatory and immunoregulatory effects of paeoniflorin and total glucosides of paeony","volume":"207","author":"Zhang","year":"2020","journal-title":"Pharmacol Ther"},{"key":"B20","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/s0046-8177(99)90301-5","article-title":"Chronic recurrent multifocal osteomyelitis in children: diagnostic value of histopathology and microbial testing","volume":"30","author":"Girschick","year":"1999","journal-title":"Hum Pathol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.clim.2015.09.013","article-title":"Altered expression of IL-10 family cytokines in monocytes from CRMO patients result in enhanced IL-1beta expression and release","volume":"161","author":"Hofmann","year":"2015","journal-title":"Clin Immunol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.clim.2011.08.012","article-title":"Chronic non-bacterial osteomyelitis is associated with impaired Sp1 signaling, reduced IL10 promoter phosphorylation, and reduced myeloid IL-10 expression","volume":"141","author":"Hofmann","year":"2011","journal-title":"Clin Immunol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.clim.2012.07.012","article-title":"Attenuated TLR4\/MAPK signaling in monocytes from patients with CRMO results in impaired IL-10 expression","volume":"145","author":"Hofmann","year":"2012","journal-title":"Clin Immunol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3390\/biom11030367","article-title":"Majeed syndrome: a review of the clinical, genetic and immunologic features","volume":"11","author":"Ferguson","year":"2021","journal-title":"Biomolecules"},{"key":"B25","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1038\/ni.3777","article-title":"The monogenic autoinflammatory diseases define new pathways in human innate immunity and inflammation","volume":"18","author":"Manthiram","year":"2017","journal-title":"Nat Immunol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e0169687","DOI":"10.1371\/journal.pone.0169687","article-title":"Recessive coding and regulatory mutations in FBLIM1 underlie the pathogenesis of chronic recurrent multifocal osteomyelitis (CRMO)","volume":"12","author":"Cox","year":"2017","journal-title":"PLoS One"},{"key":"B27","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s12969-020-00447-4","article-title":"High prevalence of rare FBLIM1 gene variants in an Italian cohort of patients with chronic non-bacterial osteomyelitis (CNO)","volume":"18","author":"d'Adamo","year":"2020","journal-title":"Pediatr Rheumatol Online J"},{"key":"B28","doi-asserted-by":"publisher","first-page":"103183","DOI":"10.1016\/j.jaut.2024.103183","article-title":"P2RX7 gene variants associate with altered inflammasome assembly and reduced pyroptosis in chronic nonbacterial osteomyelitis (CNO)","volume":"144","author":"Charras","year":"2024","journal-title":"J Autoimmun"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1093\/rheumatology\/key058","article-title":"The multifaceted presentation of chronic recurrent multifocal osteomyelitis: a series of 486 cases from the eurofever international registry","volume":"57","author":"Girschick","year":"2018","journal-title":"Rheumatology (Oxford)"},{"key":"B30","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1007\/s00247-020-04827-6","article-title":"Chronic nonbacterial osteomyelitis\u2014clinical and magnetic resonance imaging features","volume":"51","author":"d'Angelo","year":"2021","journal-title":"Pediatr Radiol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1186\/s12969-018-0290-5","article-title":"Chronic non bacterial osteitis- a multicentre study","volume":"16","author":"Bhat","year":"2018","journal-title":"Pediatr Rheumatol Online J"},{"key":"B32","doi-asserted-by":"publisher","first-page":"4977","DOI":"10.1007\/s00330-024-10622-w","article-title":"Chronic nonbacterial osteomyelitis and chronic recurrent multifocal osteomyelitis-usual and unusual sites of affliction","volume":"34","author":"Ruiz Santiago","year":"2024","journal-title":"Eur Radiol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e1190","DOI":"10.1542\/peds.2011-3788","article-title":"Pediatric chronic nonbacterial osteomyelitis","volume":"130","author":"Borzutzky","year":"2012","journal-title":"Pediatrics"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1111\/j.1651-2227.2011.02205.x","article-title":"Nonbacterial osteitis in children: data of a German incidence surveillance study","volume":"100","author":"Jansson","year":"2011","journal-title":"Acta Paediatr"},{"key":"B35","doi-asserted-by":"publisher","first-page":"2500","DOI":"10.1023\/a:1026695224019","article-title":"Chronic recurrent multifocal osteomyelitis associated with chronic inflammatory bowel disease in children","volume":"44","author":"Bousvaros","year":"1999","journal-title":"Dig Dis Sci"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1520","DOI":"10.1053\/jpsu.2000.16431","article-title":"Chronic recurrent multifocal osteomyelitis associated with ulcerative colitis: a case report","volume":"35","author":"Bazrafshan","year":"2000","journal-title":"J Pediatr Surg"},{"key":"B37","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1097\/00000441-199802000-00010","article-title":"Chronic recurrent multifocal osteomyelitis associated with crohn\u2019s disease","volume":"315","author":"Bognar","year":"1998","journal-title":"Am J Med Sci"},{"key":"B38","doi-asserted-by":"publisher","first-page":"1504","DOI":"10.1093\/rheumatology\/key143","article-title":"The multifaceted presentation of chronic recurrent multifocal osteomyelitis: a series of 486 cases from the eurofever international registry","volume":"57","author":"Girschick","year":"2018","journal-title":"Rheumatology (Oxford)"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1016\/j.rcl.2017.04.009","article-title":"SAPHO And recurrent multifocal osteomyelitis","volume":"55","author":"Greenwood","year":"2017","journal-title":"Radiol Clin North Am"},{"key":"B40","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s12969-019-0353-2","article-title":"Chronic non-bacterial osteomyelitis: a comparative study between children and adults","volume":"17","author":"Skrabl-Baumgartner","year":"2019","journal-title":"Pediatr Rheumatol Online J"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.1080\/1744666X.2023.2218088","article-title":"Classification and management strategies for paediatric chronic nonbacterial osteomyelitis and chronic recurrent multifocal osteomyelitis","volume":"19","author":"Singhal","year":"2023","journal-title":"Expert Rev Clin Immunol"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1111\/jdv.18172","article-title":"Does SAPHO syndrome exist in dermatology?","volume":"36","author":"Chen","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s12969-022-00772-w","article-title":"Two phenotypes of chronic recurrent multifocal osteomyelitis with different patterns of bone involvement","volume":"20","author":"Cebecauerova","year":"2022","journal-title":"Pediatr Rheumatol Online J"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.3899\/jrheum.161255","article-title":"Treatment response and longterm outcomes in children with chronic nonbacterial osteomyelitis","volume":"44","author":"Schnabel","year":"2017","journal-title":"J Rheumatol"},{"key":"B45","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1007\/s00223-018-0495-0","article-title":"Chronic non-bacterial osteomyelitis: a review","volume":"104","author":"Buch","year":"2019","journal-title":"Calcif Tissue Int"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.3899\/jrheum.141026","article-title":"Whole-body magnetic resonance imaging in chronic recurrent multifocal osteomyelitis: clinical longterm assessment may underestimate activity","volume":"42","author":"Voit","year":"2015","journal-title":"J Rheumatol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1186\/s12969-025-01135-x","article-title":"Preliminary validation of a web-based MRI scoring system for children with chronic nonbacterial osteomyelitis (ChRonic nonbacterial osteomyelitis magnetic resonance imaging scoring: cROMRIS)","volume":"23","author":"Nuruzzaman","year":"2025","journal-title":"Pediatr Rheumatol Online J"},{"key":"B48","doi-asserted-by":"publisher","first-page":"106905","DOI":"10.1016\/j.crad.2025.106905","article-title":"Challenges in the imaging and diagnosis of chronic non-bacterial osteomyelitis (CNO)","volume":"85","author":"Sheikh","year":"2025","journal-title":"Clin Radiol"},{"key":"B49","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1093\/rheumatology\/kex066","article-title":"Chronic recurrent multifocal osteomyelitis in children and adults: current understanding and areas for development","volume":"57","author":"Roderick","year":"2018","journal-title":"Rheumatology (Oxford)"},{"key":"B50","doi-asserted-by":"publisher","first-page":"2092","DOI":"10.1007\/s00247-023-05688-5","article-title":"MRI Features of spinal chronic recurrent multifocal osteomyelitis\/chronic non-bacterial osteomyelitis in children","volume":"53","author":"Guariento","year":"2023","journal-title":"Pediatr Radiol"},{"key":"B51","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.crad.2023.12.004","article-title":"A clinico-radiological review of chronic non-bacterial osteomyelitis in paediatrics, adolescents, and adults: demystifying a forgotten differential","volume":"79","author":"Saffarzadeh","year":"2024","journal-title":"Clin Radiol"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14010061","article-title":"Machine learning algorithm: texture analysis in CNO and application in distinguishing CNO and bone marrow growth-related changes on whole-body MRI","volume":"14","author":"Forestieri","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"B53","doi-asserted-by":"publisher","first-page":"e0147523","DOI":"10.1371\/journal.pone.0147523","article-title":"Whole-Body diffusion-weighted imaging in chronic recurrent multifocal osteomyelitis in children","volume":"11","author":"Leclair","year":"2016","journal-title":"PLoS One"},{"key":"B54","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1302\/0301-620X.62B3.7410472","article-title":"Histopathological aspects of chronic recurrent multifocal osteomyelitis","volume":"62","author":"Bj0rksten","year":"1980","journal-title":"J Bone Joint Surg Br"},{"key":"B55","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1007\/s11926-020-00928-1","article-title":"New insights into adult and paediatric chronic non-bacterial osteomyelitis CNO","volume":"22","author":"Hedrich","year":"2020","journal-title":"Curr Rheumatol Rep"},{"key":"B56","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/1546-0096-11-47","article-title":"Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO)","volume":"11","author":"Hedrich","year":"2013","journal-title":"Pediatr Rheumatol Online J"},{"key":"B57","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s12969-017-0183-z","article-title":"Bone metabolism and inflammatory characteristics in 14 cases of chronic nonbacterial osteomyelitis","volume":"15","author":"Ata","year":"2017","journal-title":"Pediatr Rheumatol Online J"},{"key":"B58","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1093\/rheumatology\/keac443","article-title":"Clinical and therapeutic diversity in adult chronic nonbacterial osteomyelitis (CNO) of the sternocostoclavicular region: a meta-analysis","volume":"62","author":"Leerling","year":"2023","journal-title":"Rheumatology (Oxford)"},{"key":"B59","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/s12969-023-00851-6","article-title":"Priorities in chronic nonbacterial osteomyelitis (CNO)\u2014results from an international survey and roundtable discussions","volume":"21","author":"Mohanna","year":"2023","journal-title":"Pediatr Rheumatol Online J"},{"key":"B60","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1002\/acr.23462","article-title":"Consensus treatment plans for chronic nonbacterial osteomyelitis refractory to nonsteroidal antiinflammatory drugs and\/or with active spinal lesions","volume":"70","author":"Zhao","year":"2018","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"B61","doi-asserted-by":"publisher","first-page":"R74","DOI":"10.1186\/ar2992","article-title":"Chronic nonbacterial osteomyelitis in childhood: prospective follow-up during the first year of anti-inflammatory treatment","volume":"12","author":"Beck","year":"2010","journal-title":"Arthritis Res Ther"},{"key":"B62","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s00296-019-04400-x","article-title":"Chronic nonbacterial osteomyelitis in children: a multicenter case series","volume":"40","author":"Concha","year":"2020","journal-title":"Rheumatol Int"},{"key":"B63","doi-asserted-by":"publisher","first-page":"1956","DOI":"10.3899\/jrheum.160256","article-title":"Chronic nonbacterial osteomyelitis: pathophysiological concepts and current treatment strategies","volume":"43","author":"Hofmann","year":"2016","journal-title":"J Rheumatol"},{"key":"B64","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1007\/s00296-016-3572-6","article-title":"Unexpectedly high incidences of chronic non-bacterial as compared to bacterial osteomyelitis in children","volume":"36","author":"Schnabel","year":"2016","journal-title":"Rheumatol Int"},{"key":"B65","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.1093\/rheumatology\/ken249","article-title":"Clinical outcome in children with chronic recurrent multifocal osteomyelitis","volume":"47","author":"Catalano-Pons","year":"2008","journal-title":"Rheumatology (Oxford)"},{"key":"B66","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1002\/art.39013","article-title":"A large national cohort of French patients with chronic recurrent multifocal osteitis","volume":"67","author":"Wipff","year":"2015","journal-title":"Arthritis Rheumatol"},{"key":"B67","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s12969-015-0023-y","article-title":"Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study","volume":"13","author":"Kaiser","year":"2015","journal-title":"Pediatr Rheumatol Online J"},{"key":"B68","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s12969-025-01106-2","article-title":"Chronic non-bacterial osteomyelitis in children- five-year standardized follow-up of a prospective observational cohort in the pre-biological era","volume":"23","author":"Hofmann","year":"2025","journal-title":"Pediatr Rheumatol Online J"},{"key":"B69","doi-asserted-by":"publisher","first-page":"1505","DOI":"10.1093\/rheumatology\/keq122","article-title":"Biologic therapy in refractory chronic non-bacterial osteomyelitis of childhood","volume":"49","author":"Eleftheriou","year":"2010","journal-title":"Rheumatology (Oxford)"},{"key":"B70","doi-asserted-by":"publisher","first-page":"155521","DOI":"10.1016\/j.cyto.2021.155521","article-title":"Cytokine profile in patients with chronic non-bacterial osteomyelitis, juvenile idiopathic arthritis, and insulin-dependent diabetes mellitus","volume":"143","author":"Kostik","year":"2021","journal-title":"Cytokine"},{"key":"B71","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1007\/s00296-018-4151-9","article-title":"Comparison of different treatment approaches of pediatric chronic non-bacterial osteomyelitis","volume":"39","author":"Kostik","year":"2019","journal-title":"Rheumatol Int"},{"key":"B72","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1016\/j.jdcr.2018.06.008","article-title":"Case series of psoriasis associated with tumor necrosis factor-alpha inhibitors in children with chronic recurrent multifocal osteomyelitis","volume":"4","author":"Campbell","year":"2018","journal-title":"JAAD Case Rep"},{"key":"B73","doi-asserted-by":"publisher","first-page":"109018","DOI":"10.1016\/j.clim.2022.109018","article-title":"TNF-inhibitors or bisphosphonates in chronic nonbacterial osteomyelitis?\u2014results of an international retrospective multicenter study","volume":"238","author":"Schnabel","year":"2022","journal-title":"Clin Immunol"},{"key":"B74","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1186\/s12969-022-00746-y","article-title":"Standardized reporting and quantification of whole-body MRI findings in children with chronic non-bacterial osteomyelitis treated with pamidronate","volume":"20","author":"Andreasen","year":"2022","journal-title":"Pediatr Rheumatol Online J"},{"key":"B75","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.3899\/jrheum.181254","article-title":"Response to early-onset pamidronate treatment in chronic nonbacterial osteomyelitis: a retrospective single-center study","volume":"46","author":"Andreasen","year":"2019","journal-title":"J Rheumatol"},{"key":"B76","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/1546-0096-7-2","article-title":"Dramatic pain relief and resolution of bone inflammation following pamidronate in 9 pediatric patients with persistent chronic recurrent multifocal osteomyelitis (CRMO)","volume":"7","author":"Miettunen","year":"2009","journal-title":"Pediatr Rheumatol Online J"},{"key":"B77","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1007\/s00431-010-1188-5","article-title":"Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate","volume":"169","author":"Hospach","year":"2010","journal-title":"Eur J Pediatr"},{"key":"B78","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.3899\/jrheum.141138","article-title":"Aggressive therapy reduces disease activity without skeletal damage progression in chronic nonbacterial osteomyelitis","volume":"42","author":"Zhao","year":"2015","journal-title":"J Rheumatol"},{"key":"B79","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/s00223-023-01154-4","article-title":"Treatment effect of zoledronic acid in chronic non-bacterial osteomyelitis of the jaw: a case series","volume":"114","author":"Jansen","year":"2024","journal-title":"Calcif Tissue Int"},{"key":"B80","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1080\/03009742.2020.1769179","article-title":"Zoledronic acid monotherapy improves osteoarticular involvement in SAPHO syndrome","volume":"49","author":"Wang","year":"2020","journal-title":"Scand J Rheumatol"},{"key":"B81","doi-asserted-by":"publisher","first-page":"205","DOI":"10.55563\/clinexprheumatol\/zpgyz9","article-title":"Short-term efficacy of zoledronic acid in the treatment of 30 cases of SAPHO syndrome","volume":"42","author":"Liu","year":"2024","journal-title":"Clin Exp Rheumatol"},{"key":"B82","doi-asserted-by":"publisher","first-page":"3525","DOI":"10.1007\/s00296-011-2249-4","article-title":"Anakinra: a safe and effective first-line treatment in systemic onset juvenile idiopathic arthritis (SoJIA)","volume":"32","author":"Hedrich","year":"2012","journal-title":"Rheumatol Int"},{"key":"B83","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1038\/s41584-018-0104-7","article-title":"Long-term safety of canakinumab in systemic JIA","volume":"14","author":"McHugh","year":"2018","journal-title":"Nat Rev Rheumatol"},{"key":"B84","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.3899\/jrheum.160690","article-title":"Anakinra in a cohort of children with chronic nonbacterial osteomyelitis","volume":"44","author":"Pardeo","year":"2017","journal-title":"J Rheumatol"},{"key":"B85","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1136\/annrheumdis-2012-201818","article-title":"Efficacy of anti-IL-1 treatment in Majeed syndrome","volume":"72","author":"Herlin","year":"2013","journal-title":"Ann Rheum Dis"},{"key":"B86","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1016\/j.semarthrit.2016.10.008","article-title":"Efficacy of biologic therapy across individual juvenile idiopathic arthritis subtypes: a systematic review","volume":"46","author":"Davies","year":"2017","journal-title":"Semin Arthritis Rheum"},{"key":"B87","doi-asserted-by":"publisher","first-page":"2353","DOI":"10.2169\/internalmedicine.8473-16","article-title":"Adult-onset chronic recurrent multifocal osteomyelitis with high intensity of muscles detected by magnetic resonance imaging, successfully controlled with tocilizumab","volume":"56","author":"Sato","year":"2017","journal-title":"Intern Med"},{"key":"B88","doi-asserted-by":"publisher","first-page":"106210","DOI":"10.1016\/j.intimp.2020.106210","article-title":"The role of JAK\/STAT signaling pathway and its inhibitors in diseases","volume":"80","author":"Xin","year":"2020","journal-title":"Int Immunopharmacol"},{"key":"B89","doi-asserted-by":"publisher","first-page":"2365","DOI":"10.2147\/JIR.S353539","article-title":"New insights in the treatment of SAPHO syndrome and medication recommendations","volume":"15","author":"Cheng","year":"2022","journal-title":"J Inflamm Res"},{"key":"B90","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s12016-025-09042-5","article-title":"The role of IL-17 in systemic autoinflammatory diseases: mechanisms and therapeutic perspectives","volume":"68","author":"Zhang","year":"2025","journal-title":"Clin Rev Allergy Immunol"},{"key":"B91","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1186\/s13075-023-03195-4","article-title":"Long-term follow-up of children with chronic non-bacterial osteomyelitis-assessment of disease activity, risk factors, and outcome","volume":"25","author":"Reiser","year":"2023","journal-title":"Arthritis Res Ther"},{"key":"B92","doi-asserted-by":"publisher","first-page":"e70061","DOI":"10.1002\/acr2.70061","article-title":"Assessing disease activity in pediatric chronic nonbacterial osteomyelitis: a proposal for composite scoring, including inactivity measures","volume":"7","author":"Reiser","year":"2025","journal-title":"ACR Open Rheumatol"},{"key":"B93","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.3899\/jrheum.2022-1323","article-title":"Feasibility of conducting comparative effectiveness research and validation of a clinical disease activity score for chronic nonbacterial osteomyelitis","volume":"50","author":"Wu","year":"2023","journal-title":"J Rheumatol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1747342\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T06:50:37Z","timestamp":1772175037000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1747342\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":93,"alternative-id":["10.3389\/fped.2026.1747342"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1747342","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]},"article-number":"1747342"}}