Chronic nonbacterial osteomyelitis (CNO), which is also known as chronic recurrent multifocal osteomyelitis (CRMO) is a rare inflammatory bone disease (OMIM 259680). It predominantly affects children and adolescents. These children usually present with localised bone pain which may be associated with swelling or loss of function depending on the site involved. Less commonly, they may also present with pathological fracture of the affected bone. Most children are otherwise well and the onset of bone pain or swelling may be gradual. However, some are systemically unwell with fever and markedly raised inflammatory markers. In adults, similar bony inflammation is seen in Synovitis Acne Pustulosis HyperOstosis (SAPHO) syndrome; CNO and SAPHO may be represent different phenotypes of the same inflammatory process.
Challenges of a rare disease
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