Learning objectives
To present and discuss a spectrum of imaging findings in four patients (three adults and one child) diagnosed with SAPHO / CRMO syndrome.
Background
SAPHO is an acronym for the following conditions: synovitis,
acne,
pustulosis,
hyperostosis and osteitis.
It represents a spectrum of inflammatory bone lesions which may or may not be associated with dermatological lesions,
with negative bacterial cultures and a clinical course characterized by relapses and remissions.
The main target area of skeletal involvement is the anterior chest wall,
followed by spine,
pelvis and long bones.
Many authors believe that chronic recurrent multifocal osteomyelitis (CRMO) is the pediatric presentation for the SAPHO syndrome.
The most common sites...
Imaging findings OR Procedure Details
We reviewed the radiographic,
CT and MR imaging findings of four patients,
three adults and a child,
with a final diagnosis of CRMO or SAPHO.
Patients presented with non specific complaints,
such as pain,
tenderness and swelling at the involved site or sites.
All had a protracted clinical course characterized by cronicity.
The diagnosis was confirmed by means of bone biopsy and negative bone cultures in 3 of the 4 patients.
Biopsy was not performed in patient 3,
but the diagnosis was based on clinical...
Conclusion
SAPHO and CRMO are diagnoses of exclusion.
It is important that radiologists are familiar with the imaging findings of these diseases because they may be the first to suggest this diagnosis.
The diagnosis SAPHO/ CRMO should be suspected when the typical osteoarticular lesions are located in characteristic target sites and skin disease is present.
References
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SAPHO: rare or just...
Personal Information
This work comes from the Radiology Department of University General Hospital Attikon,
Athens,
Greece.
First author: Radiology Resident M.Sc Angeliki Kalpaxi
[email protected].