中国实用儿科杂志

中国实用儿科杂志 ›› 2025, Vol. 40 ›› Issue (9): 734-740.DOI: 10.19538/j.ek2025090606

• 专题笔谈 • 上一篇    下一篇

儿童慢性无菌性骨髓炎的诊断与治疗

  

  1. 南京医科大学附属儿童医院风湿免疫科，江苏  南京  210008
  • 出版日期:2025-09-06 发布日期:2025-10-20
  • 通讯作者: 俞海国，电子信箱：haiguo_yu@njmu.edu.cn
  • 基金资助:
    国家自然科学基金项目（82271838）；国家重点研发计划项目（2021YFC2702000）

Diagnosis and management of chronic nonbacterial osteomyelitis in children

  1. Department of Rheumatology and Immunology，Children’s Hospital of Nanjing Medical University，Nanjing  210008，China
  • Online:2025-09-06 Published:2025-10-20

摘要： 慢性无菌性骨髓炎是一种以反复发作的无菌性骨髓炎为特征的罕见的自身炎症性骨病。病变主要累及前胸壁、长骨和脊柱等，表现为单一病灶或多病灶骨髓炎症引起的夜间性骨痛。该病病程呈慢性隐匿性进展，临床表现异质性显著，延迟治疗可导致不可逆的骨破坏。文章从发病机制、临床表现、诊断标准、鉴别诊断以及治疗策略等方面对该病进行回顾及总结，旨在提高儿科医生对该病的认识，为规范化诊疗提供理论依据。

关键词: 慢性无菌性骨髓炎, 慢性复发性多灶性骨髓炎, 自身炎症性骨病

Abstract: Chronic nonbacterial osteomyelitis is a rare autoinf-lammatory bone disease characterized by recurrent nonbacterial osteomyelitis. The lesions mainly affect long bones，spine，and anterior chest wall，presenting as nocturnal bone pain caused by single or multiple bone marrow inflammations. The disease progresses chronically and insidiously，with significant heterogeneity in clinical manifestations. Delayed treatment can lead to irreversible bone destruction. This article reviews and summarizes the disease from aspects such as pathogenesis，clinical manifestations，diagnostic criteria，differential diagnosis，and treatment strategies，aiming to improve pediatricians' understanding of the disease and provide a theoretical basis for standardized diagnosis and treatment.

Key words: chronic nonbacterial osteomyelitis, chronic recurrent multifocal osteomyelitis, autoinflammatory bone disease