vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v15i1.1498vsp-1580Research ArticleНЕПРЕРЫВНОЕ ПРОФЕССИОНАЛЬНОЕ ОБРАЗОВАНИЕPROFESSIONAL DEVELOPMENTХронический небактериальный («стерильный») остеомиелит в практике детского ревматолога, современные подходы к диагностике и лечению: обзор литературы и анализ собственных данныхChronic Non-Bacterial («Sterile») Osteomyelitis in the Practice of Pediatric Rheumatologist, the Contemporary Diagnostic and Treatment Approaches: Literature Review and Own Data AnalysisКопчакО. Л.KopchakO. L.

Санкт-Петербург;

 врач-ревматолог, 610000, Киров, ул. Менделеева, д. 16

Saint-Petersburg;

Kirov

olgakopchak@mail.ruКостикМ. М.KostikM. M.

Санкт-Петербург

Saint-Petersburg

МушкинА. Ю.MushkinA. Yu.

Санкт-Петербург

Saint-Petersburg

Санкт-Петербургский государственный педиатрический медицинский университет; Кировская детская областная больницаРоссияSaint-Petersburg State Pediatric Medical University; Kirov Regional Children’s HospitalRussian FederationСанкт-Петербургский государственный педиатрический медицинский университетРоссияSaint-Petersburg State Pediatric Medical UniversityRussian FederationСанкт-Петербургский научно-исследовательский институт фтизиопульмонологииРоссияSaint-Petersburg Research Institute of PhthisiopulmonologyRussian Federation2016240220161513344Copyright © Копчак О.Л., Костик М.М., Мушкин А.Ю., 20162016Копчак О.Л., Костик М.М., Мушкин А.Ю.Kopchak O.L., Kostik M.M., Mushkin A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/1580

В статье представлены современные данные о патогенезе, особенностях клинических проявлений и диагностике различных вариантов хронического небактериального («стерильного») остеомиелита (ХНО, англ. chronic non-bacterial osteomyelitis, CNO). Приведено описание наследственных форм заболевания, таких как синдромы дефицита антагониста интерлейкина 1 (DIRA), стерильного гнойного артрита в сочетании с гангренозной пиодермией и акне (PAPA-синдром), дизэритропоэтической анемии в сочетании с хроническим небактериальным остеомиелитом (Majeed-синдром). В основе патогенеза ХНО и родственных заболеваний лежит гиперпродукция провоспалительных цитокинов, в частности интерлейкина-1β и фактора некроза опухоли α. Приведены основанные на данных литературы и собственных наблюдениях рекомендации по диагностике и лечению ХНО.

The article presents the current data on the pathogenesis, features of clinical manifestations, and diagnostics of different variants of chronic non-bacterial («sterile») osteomyelitis (CNO). The inherited forms of the disease, such as syndromes of deficiency of the interleukin-1 receptor antagonist (DIRA), sterile pyarthrosis with pyoderma gangrenosum and acne (PAPA-syndrome), dyserythropoietic anemia with chronic non-bacterial osteomyelitis (Majeed-syndrome) are described. The pathogenesis of CNO and related diseases is based on hyperproduction of proinflammatory cytokines, particularly of interleukin-1β and tumor necrosis factor-α. Based on the literature data and our own observations, the recommendations for diagnostics and treatment of CNO are presented.

хронический небактериальный остеомиелитдиагностические критериибисфосфонатыингибиторы фактора некроза опухоли αchronic non-bacterial osteomyelitis (CNO)diagnostic criteriabisphosphonatestumor necrosis factor-α inhibitorsReferencesMiettunen PM, Wei X, Kaura D, Reslan WA, Aguirre AN, Kellner JD. Dramatic pain and resolution of bone inflammation following pamidronate in 9 patients with persistent chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol. 2009;7:2.Miettunen PM, Wei X, Kaura D, Reslan WA, Aguirre AN, Kellner JD. Dramatic pain and resolution of bone inflammation following pamidronate in 9 patients with persistent chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol. 2009;7:2.Tsitsami E, Dermentzoglou V, Moschovi M, Chrousos GP. Chronic recurrent multifocal osteomyelitis with contaminant futures of juvenile idiopathic arthritis. Case Rep Rheumatol. 2011; 2011:210795.Tsitsami E, Dermentzoglou V, Moschovi M, Chrousos GP. Chronic recurrent multifocal osteomyelitis with contaminant futures of juvenile idiopathic arthritis. Case Rep Rheumatol. 2011; 2011:210795.Maandell GA, Conteras SJ, Conard KH, Harcke T and Maas KW. Bone Scintigraphy in the Detection of Chronic Reccurent Multifocal Osteomyelitis. J Nucl Med. 1998;39(10):1778–1783.Maandell GA, Conteras SJ, Conard KH, Harcke T and Maas KW. Bone Scintigraphy in the Detection of Chronic Reccurent Multifocal Osteomyelitis. J Nucl Med. 1998;39(10):1778–1783.Jansson A, Renner ED, Ramser J, Mayer A, Haban M, Meindl A, Grote V, Diebold J, Jansson V, Schneider K, Belohradsky BH. Classification of non-bacterial osteitis retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatology. 2007;46:154–160.Jansson A, Renner ED, Ramser J, Mayer A, Haban M, Meindl A, Grote V, Diebold J, Jansson V, Schneider K, Belohradsky BH. Classification of non-bacterial osteitis retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatology. 2007;46:154–160.Borzutzky A, Stern S, Reiff A, Zurakowski D, Steinberg EA, Dedeoglu F, Sundel RP. Pediatric chronic nonbacterial osteomyelitis. Pediatrics. 2012;130(5):1190–1197.Borzutzky A, Stern S, Reiff A, Zurakowski D, Steinberg EA, Dedeoglu F, Sundel RP. Pediatric chronic nonbacterial osteomyelitis. Pediatrics. 2012;130(5):1190–1197.Hofmann SR, Schwarz T, Moller JC, Morbach H, Schnabel A, Rosen-Wolff A, Girschick HJ, Hedrich CM. Chronic non-bacterial osteomyelitis is associated with impaired Sp1 signaling, reduced IL10 promoter phosphorylation, and reduced myeloid IL-10 expression. Clin Immunol. 2011;141(3):317–327.Hofmann SR, Schwarz T, Moller JC, Morbach H, Schnabel A, Rosen-Wolff A, Girschick HJ, Hedrich CM. Chronic non-bacterial osteomyelitis is associated with impaired Sp1 signaling, reduced IL10 promoter phosphorylation, and reduced myeloid IL-10 expression. Clin Immunol. 2011;141(3):317–327.Hofmann SR, Rosen-Wolff A, Tsokos GC, Hedrich CM. Biological properties and regulation of IL-10 related cytokines and their contribution to autoimmune disease and tissue injury. Clin Immunol. 2012;143(2):116–127.Hofmann SR, Rosen-Wolff A, Tsokos GC, Hedrich CM. Biological properties and regulation of IL-10 related cytokines and their contribution to autoimmune disease and tissue injury. Clin Immunol. 2012;143(2):116–127.Coll RC, Robertson AA, Chae JJ, Higgins SC, Munoz-Planillo R, Inserra MC, Vetter I, Dungan LS, Monks BG, Stutz A, Croker DE, Butler MS, Haneklaus M, Sutton CE, Nunez G, Latz E, Kastner DL, Mills KH, Masters SL, Schroder K, Cooper MA, O'Neill LA. A small molecule inhibitior of the NLRP3 inflammasome is a potential therapeutic for inflammatory diseases. Nat Med. 2015;21(3):248–255.Coll RC, Robertson AA, Chae JJ, Higgins SC, Munoz-Planillo R, Inserra MC, Vetter I, Dungan LS, Monks BG, Stutz A, Croker DE, Butler MS, Haneklaus M, Sutton CE, Nunez G, Latz E, Kastner DL, Mills KH, Masters SL, Schroder K, Cooper MA, O'Neill LA. A small molecule inhibitior of the NLRP3 inflammasome is a potential therapeutic for inflammatory diseases. Nat Med. 2015;21(3):248–255.Deutschmann A, Mache CJ, Bodo K, Zebedin D, Ring E. Successful Treatment of Chronic Recurrent Multifocal Osteomyelitis With Tumor Necrosis Factor Blockage. Pediatrics. 2005;116:1231–1233.Deutschmann A, Mache CJ, Bodo K, Zebedin D, Ring E. Successful Treatment of Chronic Recurrent Multifocal Osteomyelitis With Tumor Necrosis Factor Blockage. Pediatrics. 2005;116:1231–1233.Schroder K, Tschopp J. The Inflammasomes. Cell. 2010; 140(6):821–832.Schroder K, Tschopp J. The Inflammasomes. Cell. 2010; 140(6):821–832.Lats E, Xido TS, Startz A. Activation and regulation of the inflammasomes. Nut Rev Immunol. 2013;13(6):347–411.Lats E, Xido TS, Startz A. Activation and regulation of the inflammasomes. Nut Rev Immunol. 2013;13(6):347–411.Yu JR, Leslie KS. Cryopyrin Associated Periodic Syndrome: An Update on Diagnosis and Treatment Response. Curr Allergy Asthma Rep. 2011;11(1):12–20.Yu JR, Leslie KS. Cryopyrin Associated Periodic Syndrome: An Update on Diagnosis and Treatment Response. Curr Allergy Asthma Rep. 2011;11(1):12–20.Scianaro R, Insalaco A, Laudiero LB, De Vito R, Pezzullo M, Teti A, De Benedetti F, Prencipe G. Deregulation of the IL-1 axis in chronic recurrent multifocal osteomyelitis. Pediatr Rheumatol. 2014;12:30.Scianaro R, Insalaco A, Laudiero LB, De Vito R, Pezzullo M, Teti A, De Benedetti F, Prencipe G. Deregulation of the IL-1 axis in chronic recurrent multifocal osteomyelitis. Pediatr Rheumatol. 2014;12:30.Gabay C, Palmer G. Mutationts in the IL1RN locus lead to autoinflammatiion. Nat Rev Rheumatol. 2009;9:480–482.Gabay C, Palmer G. Mutationts in the IL1RN locus lead to autoinflammatiion. Nat Rev Rheumatol. 2009;9:480–482.Greenhull CJ, Jones GW, Nowell VA, Newton Z, Harvey AK, Noideen AN. Interleikin-10 regulates the inflammasome driven augmentation of inflammatory arthritis and joint destruction. Arthritis Res & Ther. 2014;16:419.Greenhull CJ, Jones GW, Nowell VA, Newton Z, Harvey AK, Noideen AN. Interleikin-10 regulates the inflammasome driven augmentation of inflammatory arthritis and joint destruction. Arthritis Res & Ther. 2014;16:419.Gikas PD, Islam L, Aston W, Tirabosco R, Saifuddin A, Briggs TW, Cannon SR, O'Donnell P, Jacobs B. Flanagan Nonbacterial osteitis: a clinical, histopathological, and imaging study with a proposal for protocol-based management of patients with this diagnosis. Am J Orthop Sci. 2009;14(5):505–516.Gikas PD, Islam L, Aston W, Tirabosco R, Saifuddin A, Briggs TW, Cannon SR, O'Donnell P, Jacobs B. Flanagan Nonbacterial osteitis: a clinical, histopathological, and imaging study with a proposal for protocol-based management of patients with this diagnosis. Am J Orthop Sci. 2009;14(5):505–516.Schults HI, Ferguson PJ. Chronic recurrent multifocal osteomyelitis: a concise review and genetic update. Clin Orthop Relat Ress. 2007;462:11–19.Schults HI, Ferguson PJ. Chronic recurrent multifocal osteomyelitis: a concise review and genetic update. Clin Orthop Relat Ress. 2007;462:11–19.Ferguson PJ. Current Understating of the Pathogenesis and Management of Chronic Reccurent Multifocal Osteomyelitis. Curr Reumatol Rep. 2012;14(2):130–141.Ferguson PJ. Current Understating of the Pathogenesis and Management of Chronic Reccurent Multifocal Osteomyelitis. Curr Reumatol Rep. 2012;14(2):130–141.Teixeira SR, Elias Junior J, Nogueira-Barbosa MH, Guimaraes MD, Marchiori E, Santos MK. Whole body magnetic resonance imaging in children: state of the art. Radiol Bras. 2015;48(2):111–120.Teixeira SR, Elias Junior J, Nogueira-Barbosa MH, Guimaraes MD, Marchiori E, Santos MK. Whole body magnetic resonance imaging in children: state of the art. Radiol Bras. 2015;48(2):111–120.von Kalle T, Heim N, Hospach T, Langendorfer M, Winkler P, Stuber T. Typical Pattern of Bone Involvement in Whole Body MRI of Patients with Chronic Reccurent Multifocal Osteomyelitis (CRMO). Rofo. 2013;185(7):655–661.von Kalle T, Heim N, Hospach T, Langendorfer M, Winkler P, Stuber T. Typical Pattern of Bone Involvement in Whole Body MRI of Patients with Chronic Reccurent Multifocal Osteomyelitis (CRMO). Rofo. 2013;185(7):655–661.Herregods N, Dehoorne J, Pattyn E, Jaremko JL, Baraliakos X, Elewaut D. Diagnostic valvue of pelvic entesities on MRI of the sacroiliac joints in entesitis related arthritis. Pediatric Rheumatology. 2015;13:46.Herregods N, Dehoorne J, Pattyn E, Jaremko JL, Baraliakos X, Elewaut D. Diagnostic valvue of pelvic entesities on MRI of the sacroiliac joints in entesitis related arthritis. Pediatric Rheumatology. 2015;13:46.Дьячкова ГВ, Митина ЮЛ, Клюшин НМ, Корабельников МА. Возможности КТ в диагностике хронического остеомиелита бедренной кости. Гений ортопедии. 2003;2:72–76.Дьячкова ГВ, Митина ЮЛ, Клюшин НМ, Корабельников МА. Возможности КТ в диагностике хронического остеомиелита бедренной кости. Гений ортопедии. 2003;2:72–76.Pineda C, Espinosa R, Pena A. Radiographic Imaging in Osteomyelitis: The Role of Plain Radiography, Computed Tomography, Ultrasonography, Magnetic Resonanse Imaging, and Scintigraphy. Semin Plast Surg. 2009;23(2):80–89.Pineda C, Espinosa R, Pena A. Radiographic Imaging in Osteomyelitis: The Role of Plain Radiography, Computed Tomography, Ultrasonography, Magnetic Resonanse Imaging, and Scintigraphy. Semin Plast Surg. 2009;23(2):80–89.Colmenero JD, Ruiz-Mesa JD, Sanjuan-Simenez R, Sobrino B, Morata P. Establishing the diagnosis of tuberculosus vertebral osteomyelitis. Eur spine J (2013)22(suppl 4):S579-S586Colmenero JD, Ruiz-Mesa JD, Sanjuan-Simenez R, Sobrino B, Morata P. Establishing the diagnosis of tuberculosus vertebral osteomyelitis. Eur spine J (2013)22(suppl 4):S579-S586Cassel SL, Janczy JR, Bing X, Wilson SP, Olivier AK, Otero JE. Inflammasome-independent IL-1 mediates autoinflammatory disease in Pstpip2 deficient mice. Proc Natl Acad Sci USA. 2014;21;111(3):1072–1077.Cassel SL, Janczy JR, Bing X, Wilson SP, Olivier AK, Otero JE. Inflammasome-independent IL-1 mediates autoinflammatory disease in Pstpip2 deficient mice. Proc Natl Acad Sci USA. 2014;21;111(3):1072–1077.Watanabe T, Ono H, Morimoto Y, Otsuki Y, Shirai M, Endoh A. Skull involvement in a pediatric case of chronic recurrent multifocal osteomyelitis. Nagoya J Med Sci. 2015;77(3):493–500.Watanabe T, Ono H, Morimoto Y, Otsuki Y, Shirai M, Endoh A. Skull involvement in a pediatric case of chronic recurrent multifocal osteomyelitis. Nagoya J Med Sci. 2015;77(3):493–500.Jansson AF, Muller TH, Gliera L, Ankerst DP, Wintergerst U, Belohradsky BH, Jansson V. Clinical score for nonbacterial osteitis in children and adults. Arthritis Rheum. 2009;60(4):1152–1159.Jansson AF, Muller TH, Gliera L, Ankerst DP, Wintergerst U, Belohradsky BH, Jansson V. Clinical score for nonbacterial osteitis in children and adults. Arthritis Rheum. 2009;60(4):1152–1159.Stern SH, Ferguson PJ. Autoinflammatory Bone Diseases. Rheum Dis Clin North Am. 2013;39(4):735–749.Stern SH, Ferguson PJ. Autoinflammatory Bone Diseases. Rheum Dis Clin North Am. 2013;39(4):735–749.Naik HB, Cowen EW. Autoinflammatory pustular neutrophilic diseases. Dermatol Clin. 2013;31(3):405–425.Naik HB, Cowen EW. Autoinflammatory pustular neutrophilic diseases. Dermatol Clin. 2013;31(3):405–425.Van Den Eynde M, Lecluyse K, Chioccioli C, Brouckaert M, Caussin E, Lammens P. Crohn's disease and the SAPHO syndrome during treatment with infliximab: a case report and review of literature. Gastroenterol Clin Biol. 2007;31(6–7):607–610.Van Den Eynde M, Lecluyse K, Chioccioli C, Brouckaert M, Caussin E, Lammens P. Crohn's disease and the SAPHO syndrome during treatment with infliximab: a case report and review of literature. Gastroenterol Clin Biol. 2007;31(6–7):607–610.Beretta-Piccoli BC, Sauvain MJ, Gal I, Schibler A, Saurenmann T, Kressebuch H, Bianchetti MG. Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome in childhood: a report of ten cases and review of the literature. Eur J Pediatr. 2000; 159:594–601.Beretta-Piccoli BC, Sauvain MJ, Gal I, Schibler A, Saurenmann T, Kressebuch H, Bianchetti MG. Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome in childhood: a report of ten cases and review of the literature. Eur J Pediatr. 2000; 159:594–601.Kerrison C, Davidson JE, Cleary AG, Beresford MW. Pamidronate in the treatment of childhood SAPHO syndrome. Rheumatology (Oxford). 2004;43:1246–1251.Kerrison C, Davidson JE, Cleary AG, Beresford MW. Pamidronate in the treatment of childhood SAPHO syndrome. Rheumatology (Oxford). 2004;43:1246–1251.Sfikakis PP, Iliopoulos A, Elezoglou A, Kittas C, Stratigos A. Psoriasis induced by anti-tumor necrosis factor therapy: a paradoxical adverse reaction. Аrthritis Rheum. 2005;2(8):2513–2518.Sfikakis PP, Iliopoulos A, Elezoglou A, Kittas C, Stratigos A. Psoriasis induced by anti-tumor necrosis factor therapy: a paradoxical adverse reaction. Аrthritis Rheum. 2005;2(8):2513–2518.Ferguson PJ. Current Understating of the Pathogenesis and Management of Chronic Reccurent Multifocal Osteomyelitis. Curr Reumatol Rep. 2012;14(2):130–141.Ferguson PJ. Current Understating of the Pathogenesis and Management of Chronic Reccurent Multifocal Osteomyelitis. Curr Reumatol Rep. 2012;14(2):130–141.Yoshitaka T, Ishida S, Mukai T, Kittaka M, Reichenberger EJ, Ueki Y. Etanercept administration to neonatal SH3BP2 knock in cherubism mice prevents TNF--induced inflammation and bone loss. J Bone Miner Res. 2014;29(5):1170–1182.Yoshitaka T, Ishida S, Mukai T, Kittaka M, Reichenberger EJ, Ueki Y. Etanercept administration to neonatal SH3BP2 knock in cherubism mice prevents TNF--induced inflammation and bone loss. J Bone Miner Res. 2014;29(5):1170–1182.Waite AL, Schaner P, Richards N, Balci-Peynircioglu B, Masters SL, Brydges SD, Fox M, Hong A, Yilmaz E, Kastner DL, Reinherz EL, Gumucio DL. Pyrin Modulates the Intracellular Distribution of PSTPIP1. PLoS One. 2009;4(7):6147.Waite AL, Schaner P, Richards N, Balci-Peynircioglu B, Masters SL, Brydges SD, Fox M, Hong A, Yilmaz E, Kastner DL, Reinherz EL, Gumucio DL. Pyrin Modulates the Intracellular Distribution of PSTPIP1. PLoS One. 2009;4(7):6147.Caorsi R, Picco P, Buoncompagni A, Martini A, Gattorno M. J. Osteolytic lesion in PAPA syndrome responding to anti-interleukin 1 treatment. Rheumatology. 2014;41(11):2333–2334. Doi: 10.3899/jrheum.140060.Caorsi R, Picco P, Buoncompagni A, Martini A, Gattorno M. J. Osteolytic lesion in PAPA syndrome responding to anti-interleukin 1 treatment. Rheumatology. 2014;41(11):2333–2334. Doi: 10.3899/jrheum.140060.Girshick HJ, Raab P, Surbaum S, Trusen A, Kirschner S, Schneider P, Papadopoulos T, Muller-Hermelink HK, Lipsky PE. Chronic non-bacterial osteomyelitis in children. Ann Rheum Dis. 2005;64:274–285.Girshick HJ, Raab P, Surbaum S, Trusen A, Kirschner S, Schneider P, Papadopoulos T, Muller-Hermelink HK, Lipsky PE. Chronic non-bacterial osteomyelitis in children. Ann Rheum Dis. 2005;64:274–285.Beck C, Morbach H, Beer M, Stenzel M, Tappe D, Gattenlohner S, Hofmann U, Raab P, Girschick HJ. Chronic nonbacterial osteomyelitis in childhood: prospective follow up during the first year of anti-inflammatory treatment. Arthritis Res Ther. 2010;12(2):74.Beck C, Morbach H, Beer M, Stenzel M, Tappe D, Gattenlohner S, Hofmann U, Raab P, Girschick HJ. Chronic nonbacterial osteomyelitis in childhood: prospective follow up during the first year of anti-inflammatory treatment. Arthritis Res Ther. 2010;12(2):74.Kostik M, Chikova I, Masalova V, Dubko M, Snegireva L, Isupova E, Kuchinskaya EM, Glebova NI, Buchinskaya NV, Kalashnikova OV, Chasnyk VG. Comparison of different treatment approaches in chronic non-bacterial osteomyelitis. Pediatr Rheumatol. 2015;13(1):102.Kostik M, Chikova I, Masalova V, Dubko M, Snegireva L, Isupova E, Kuchinskaya EM, Glebova NI, Buchinskaya NV, Kalashnikova OV, Chasnyk VG. Comparison of different treatment approaches in chronic non-bacterial osteomyelitis. Pediatr Rheumatol. 2015;13(1):102.Abril JC, Ramirez A. Succesful Treatment of Chronic Reccurent Multifocal Ostemyeliitis with Indometacin. J Pediatr Orthop. 2007;27(5):587–591.Abril JC, Ramirez A. Succesful Treatment of Chronic Reccurent Multifocal Ostemyeliitis with Indometacin. J Pediatr Orthop. 2007;27(5):587–591.Girschick HJ, Zimmer C, Klaus G, Darge K, Dick A, Morbach H. Chronic recurrent multifocal osteomyelitis: what is it and how should it be treated? Nat Clin Pract Rheumatol. 2007;3(12):733–738.Girschick HJ, Zimmer C, Klaus G, Darge K, Dick A, Morbach H. Chronic recurrent multifocal osteomyelitis: what is it and how should it be treated? Nat Clin Pract Rheumatol. 2007;3(12):733–738.Amy E, Kaplan FN, Lishner M, Koren G. Taking bisphosphonates during pregnancy. Can Fam Phys. 2003;49:1281–1282.Amy E, Kaplan FN, Lishner M, Koren G. Taking bisphosphonates during pregnancy. Can Fam Phys. 2003;49:1281–1282.Santra G, Sarkar RN, Phaujdar S, Banerjee S, Siddhanta S. Assessment of the efficacy of pamidronate in ankylosing spondylitis: an open prospective trial. Singapore Med J. 2010;51(11):883–887.Santra G, Sarkar RN, Phaujdar S, Banerjee S, Siddhanta S. Assessment of the efficacy of pamidronate in ankylosing spondylitis: an open prospective trial. Singapore Med J. 2010;51(11):883–887.Djokanovic N, Klieger-Grossmann C, Koren G. Does treatment with bisphosphonates endanger the human pregnancy? Obstet Gynaecol Can. 2008;30(12):1146–1148.Djokanovic N, Klieger-Grossmann C, Koren G. Does treatment with bisphosphonates endanger the human pregnancy? Obstet Gynaecol Can. 2008;30(12):1146–1148.Green SB, Pappas AL. Effects of maternal bisphosphonate use on fetal and neonatal outcomes. Health Syst Pharm. 2014; 71(23):2029–2036.Green SB, Pappas AL. Effects of maternal bisphosphonate use on fetal and neonatal outcomes. Health Syst Pharm. 2014; 71(23):2029–2036.Deutschmann A, Mache CJ, Bodo K, Zebedin D, Ring E. Successful treatment of chronic recurrent multifocal osteomyelitis with tumor necrosis factor alpha blockage. Pediatrics. 2005;116(5): 1231–1233.Deutschmann A, Mache CJ, Bodo K, Zebedin D, Ring E. Successful treatment of chronic recurrent multifocal osteomyelitis with tumor necrosis factor alpha blockage. Pediatrics. 2005;116(5): 1231–1233.Coinde E, David L, Cottalorda J, Allard D, Bost M, Lucht F, Stephan JL. Chronic recurrent multifocal osteomyelitis in children: report of 17 cases. Arch Pediatr. 2001;8(6):577–583.Coinde E, David L, Cottalorda J, Allard D, Bost M, Lucht F, Stephan JL. Chronic recurrent multifocal osteomyelitis in children: report of 17 cases. Arch Pediatr. 2001;8(6):577–583.Мушкин АЮ, Алаторцев АВ, Маламашин ДБ, Перецманас ЕО, Куклин ДВ. Информативность чрескожной биопсии в дифференциальной диагностике ограниченных деструктивных поражений позвоночника. Хирургия позвоночника. 2012;1:62–67.Мушкин АЮ, Алаторцев АВ, Маламашин ДБ, Перецманас ЕО, Куклин ДВ. Информативность чрескожной биопсии в дифференциальной диагностике ограниченных деструктивных поражений позвоночника. Хирургия позвоночника. 2012;1:62–67.

The authors declare that there are no conflicts of interest present.