Jansson et al developed a clinical score for the diagnosis of nonbacterial osteitis (NBO). The score can be used along with other clinical information to reach a final diagnosis. The authors are from Ludwig Maximilian University in Munich.
Patient selection: pediatric and adult
Parameters:
(1) blood cell count (presumed to be the complete blood count, CBC)
(2) symmetry of lesions
(3) lesions with marginal sclerosis
(4) body temperature
(5) lesions location
(6) number of radiologically-proven lesions
(7) serum C-reactive protein in mg/dL
Parameter
Findings
Points
CBC
normal
13
abnormal
0
symmetry
symmetrical
10
assymmetrical
0
marginal sclerosis in lesions
absent
0
present
10
body temperature
normal (afebrile)
9
abnormal
0
location of lesions
vertebrae, clavicles, sternum
8
other bones
0
number of radiologically-proven lesions
0 or 1
0
>= 2
7
serum CRP
< 1 mg/dL
0
>= 1 mg/dL
6
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 63
• The higher the score the greater the likelihood of NBO.
Score
Diagnosis
Performance
<= 28
probably not
NPV 97%
29 to 38
uncertain
80% NBO
>= 39
probably NBO
PPV 97%, sensitivity 68%
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