Chronic non-infectious osteomyelitis (CNO) is an autoinflammatory disorder of unknown etiology that is characterized by sterile, painful, and destructive bone lesions and has its peak incidence in childhood. Its presentation can be highly variable, and when children present with solitary lesions having an indolent course, the clinical picture and imaging features at presentation can overlap with those of Ewing sarcoma (EWS), a rare, highly malignant, primary pediatric bone tumor with a poor prognosis. Osteomyelitis is a known imaging mimic of EWS, but CNO poses a particular problem because a lack of clinical markers usually indicative of infection can cause the disease to be mistaken for a malignancy at clinical workup as well as imaging. A misdiagnosis between these two diseases may have serious repercussions for treatment and clinical course with potentially devastating effects on patient outcomes.
SPR 2022 Annual Meeting & Postgraduate Course