Treatment-Refractory Sternocostoclavicular Hyperostosis

Yachoui, Ralph; Kreidy, Mazen; Parker, Brian J.

doi:10.3121/cmr.2017.1352

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…A majority of 69% of CNO patients in the present study displayed a nociplastic pain profile alongside their nociceptive pain, as reflected by signs of central sensitization on CSI and/or symptoms consistent with fibromyalgia on FiRST or the AAPT criteria, both of which represent elements of nociplastic pain [ 15 ]. These findings align with those from multiple studies on axial spondylarthritis and a single study on adult CNO [ 19 , 42 – 45 ]. While nociplastic pain is described as pain that does not exhibit clear nociceptor activation or neuropathy [ 15 ], it is known to frequently develop within the context of chronic nociceptive pain via adaptive alterations in pain processing.…”

Section: Discussionsupporting

confidence: 89%

“…Both neuropathic and nociplastic pain have proven common in axial spondylarthritis, psoriatic arthritis and rheumatoid arthritis alongside nociceptive pain caused by inflammation. Their co-existence is associated with higher patient reported disease activity, poorer treatment outcomes, and lower quality of life [11,[18][19][20]. For adult CNO, the coexistence of these pain profiles is currently unknown, but suspected based on the notable number of patients that do not experience pain improvement despite receiving antiinflammatory treatments [21].…”

Section: Introductionmentioning

confidence: 99%

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Neuropathic and Nociplastic Pain Profiles are Common in Adult Chronic Nonbacterial Osteitis (CNO)

Leerling,

Niesters,

Flendrie

et al. 2024

Calcif Tissue Int

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Chronic nonbacterial osteitis (CNO) is a rare musculoskeletal disease causing chronic bone pain. It is known that chronic musculoskeletal pain may involve other mechanisms than nociceptive pain only. We investigate the prevalence of neuropathic and nociplastic pain in adult CNO and their association with clinical characteristics and treatment outcomes. Survey study among the Dutch adult CNO cohort (n = 84/195 participated), including PAIN-detect for neuropathic pain, and the Central Sensitization Inventory (CSI), Fibromyalgia Rapid Screening Tool (FiRST), and ACTTION-APS Pain Taxonomy (AAPT) for nociplastic pain. Clinical characteristics and CNO-related bone pain scores were compared between patients with exclusive nociceptive pain and those with nociceptive pain plus neuropathic and/or nociplastic pain (mixed pain). 31% (95% CI 21–41) of patients classified as likely having neuropathic pain according to PAIN-detect. 53% (41–64) of patients displayed central sensitization on CSI, 61% (50–72) screened positive for fibromyalgia on FiRST and 14% (7–23) of patients fulfilled the AAPT criteria, all indicative of nociplastic pain. Mixed pain was associated with longer diagnostic delay (mean difference 2.8 years, 95% CI 0.4–5.2, p = 0.023), lower educational level (72% versus 20%, p < 0.001), and opioid use (37% versus 13%, p = 0.036). Despite comparable disease severity and extent, patients with mixed pain reported significantly higher CNO-related bone pain scores. This study demonstrates the high prevalence of mixed pain in adult CNO, in which neuropathic and nociplastic pain exist alongside nociceptive inflammatory bone pain. Disease burden in CNO may extend beyond inflammatory activity, highlighting the need for a multifaceted management approach.

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