CHronic Nonbacterial Osteomyelitis International Registry (CHOIR)
Seattle Children's Hospital
Summary
The objective of the study is to establish a prospective disease registry for chronic recurrent multifocal osteomyelitis (CRMO)/chronic nonbacterial osteomyelitis (CNO) in order to investigate the natural history of the disease and the responses of patients to different clinical managements over 10 years.
Description
Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disease that mainly affects children and adolescents. Clinical presentations range from mild and sometimes limited unifocal disease to severe, chronically active or recurrent inflammation of multiple bones. The latter is referred to as chronic recurrent multifocal osteomyelitis (CRMO). Here we will use the term "CNO" to refer to the entire spectrum of this disease. CNO can be complicated by vertebral compression fractures, kyphosis, and leg length discrepancy when it is not recognized early or treated adequately. The diagnosi…
Eligibility
- Age range
- Up to 21 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * \- Age at enrollment is equal to or younger than 21 years of age * Presence of bone edema on STIR or T2 fat saturation sequence on MRI within 12 weeks of enrollment * Whole body imaging evaluation (either WB MRI or bone scintigraphy) * Bone biopsy to exclude infection or malignancy unless bone lesions follow typical distribution or there is IBD, psoriasis, or palmar plantar pustulosis Exclusion Criteria: * \- History of or current malignancy * Current infectious osteomyelitis * Contraindication to the selected treatment agent
Interventions
- DrugMethotrexate
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
- DrugSulfasalazine
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
- DrugLeflunomide
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
- DrugPamidronate
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
- DrugZoledronic acid
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
- DrugEtanercept
second-line treatment for children with CNO/CRMO after failure to respond to NSAIDs
Location
- Seattle Children's HospitalSeattle, Washington