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

IF 2.3 Q2 RHEUMATOLOGY
Yongdong Zhao, F. Dedeoğlu, P. Ferguson, S. Lapidus, R. Laxer, M. Bradford, Suzanne C. Li
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引用次数: 34

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.
医师对慢性非细菌性骨髓炎诊断和治疗的看法
背景/目的。了解儿童风湿病学家在诊断和治疗慢性非细菌性骨髓炎(CNO)方面的做法,可以为指导制定一致的治疗计划提供重要信息。本研究的目的是确定医生的方法:(1)诊断和监测CNO,(2)安排骨活检,以及(3)做出治疗决定。方法。一项调查使用网络问卷在儿童关节炎和风湿病研究联盟的成员中分发。后果277名主治医师中有121人(41%)完成了调查。最常用的是平片(89%),其次是区域MRI(78%)、骨闪烁扫描(43%)和全身MRI(36%)。进行活检的前三个原因是体质检查结果(66%)、单灶性骨病变(64%)和夜间骨痛(45%)。几乎所有应答者(95%)都开了非甾体抗炎药(NSAIDs)作为初始治疗。对于NSAID治疗失败的患者,甲氨蝶呤(67%)、肿瘤坏死因子抑制剂(65%)和双磷酸盐(46%)是次常用的治疗方法。脊柱损伤的存在增加了双磷酸盐治疗的使用。结论CNO的诊断方法和疾病活动监测在接受调查的医生中各不相同。我们的调查结果为制定一致的CNO治疗计划提供了重要背景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
9
审稿时长
24 weeks
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