Autoinflammatory & rare systemic diseases
Expert consensus recommendations for the diagnosis and treatment of chronic non-bacterial osteitis (CNO) in adults
Methodological detailssystematic literature review, GRADE-based appraisal of evidence, two Delphi surveys, three digital and in-person consensus meetings, multidisciplinary expert panel and patient representatives
- Systematic literature review
- GRADE-based appraisal of evidence
- Two Delphi surveys
- Three digital and in-person consensus meetings
- Multidisciplinary expert panel and patient representatives
Recommendations
As issued by the authors
The term 'chronic non-bacterial osteitis' (CNO) is proposed to describe adults with sterile bone inflammation.
For initial imaging evaluation of suspected CNO: MRI or otherwise CT combined with nuclear imaging.
Whole-body imaging at initial evaluation can be considered for diagnostic and prognostic purposes.
Suggested first-line treatment in active CNO: NSAIDs/cyclooxygenase 2-inhibitors.
Second-line treatment preferably IV bisphosphonates, otherwise TNFi; choice individualised, considering additional inflammatory features.
Original publication
Expert consensus recommendations for the diagnosis and treatment of chronic non-bacterial osteitis (CNO) in adults. Ann Rheum Dis. Published 2 January 2025. doi:10.
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