A rare case of chronic nonbacterial osteomyelitis of the mandible in a young adult male

Abstract

Chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis, is a rare disease of unknown etiology mainly affecting girls with a mean age of 10 years. The disease is characterized by nonbacterial osteolytic lesions and swelling of the adjacent soft tissues and has nonstandard treatment protocols. Unifocal CNO typically involves the mandible. Mandibular CNO is difficult to differentiate from bacterial osteomyelitis because of its similar radiographic profile and clinical symptoms. Therefore, magnetic resonance imaging (MRI) should be considered if infectious osteomyelitis has not been diagnosed by laboratory examination. Our patient was a young adult man with mandibular CNO presented with atypical bone fragments on MRI. Clinical symptoms improved within 3 days after surgical intervention to remove the fragments and treatment with a nonsteroidal anti-inflammatory drug (NSAID). NSAID therapy was discontinued at postoperative day 20, and the patient has experienced no recurrences at 5 months after surgery.