Fig. 4

Radiographic findings at diagnosis in four patients (P1-4) with CNO and extraosseous complications. P1. A FDG-PET/CT revealed an abnormal accumulation in the bilateral distal tibia and tarsal bones. B T2 prolongation and augmentation effects on the bilateral distal tibia and tarsus indicate bone marrow edema in foot MRI. C Sagittal MRI view in foot MRI. D Acne vulgaris on bilateral limbs observed during follow-up. P2. E FDG-PET/CT revealed irregularities and an abnormal accumulation in the right clavicle. F The swollen right clavicle showed T2 prolongation and enhancement of internal and surrounding soft tissues, indicating edematous changes in MRI. P3. The proximal left tibial lesion in MRI (G) and FDG-PET/CT (H). P4. FDG-PET/CT and MRI revealed bone lesions in the right mandible (I and J) and left sacrum (K and L), respectively. Edematous bone lesions with swelling of the surrounding soft tissues in MRI. P4 presented a nail deformity due to psoriasis (M), and pyoderma (N). FDG-PET/CT: fludeoxyglucose-positron emission tomography/computed tomography. White arrows indicate lesions