Learning objectives
- To provide educational review of different stages of SAPHO in children and adults.
- To illustrate the multi-modality imaging appearances of SAPHO.
Background
SAPHO is an acronym coined by Chamot et al in 1987 describing the association between musculoskeletal and skin lesions.
The condition has different stages with wide range of imaging features and sometimes it is difficult to differentiate it from sinister pathology which can lead to unnecessary invasive investigations.
Imaging findings OR Procedure Details
SAPHO is an acronym that is manifested by a combined occurrence of
S: synovitis
A: acne
P: pustulosis
H: hyperostosis
O: osteitis
It is an inflammatory condition with predominant non-infective osteoarticular involvement.
It is seen in all ages,
however,
classically tends to present in young to middle aged adults.
There is slight female predisposition.
The appearances of the osteitis can be very aggressive mimicking infection or neoplasm.
Chronic recurrent multifocal osteomyelitis (CRMO) is the association of multifocal osteitis with pustulosis palmaris et plantaris seen in...
Conclusion
The radiologist plays a vital role in the early diagnosis of this condition,
however,
atypical appearances are common and so it is very crucial to be fully aware of the spectrum of the radiological appearances to prevent the unnecessary use of long-term antibiotics or invasive procedures.
References
Hayem G,
Bouchaud-Chabot A,
Benali K,
et al.
SAPHO syndrome: a longtermfollow-up study of 120 cases.
Semin Arthritis Rheum 1999;29:159-71.
Maugars Y,
Berthelot JM,
Ducloux JM,
et al.
SAPHO syndrome: a followup study of 19 cases with special emphasis on enthesis involvement.
J Rheumatol 1995;22:2135-41.
Benhamou CL,
Chamot AM,
Kahn MF. Synovitis- acne-pustulosis- hyperostosis-osteomyelitis syndrome (SAPHO).
A newsyndrome among the spondyloarthropathies? Clin Exp Rheumatol 1988;6:109-12.
R.
Depasquale,
N.
Kumar,
R.K.
Lalam,
B.J.
Tins,
P.N.M.
Tyrrell,
J.
Singh,
V.N.
Cassar-Pullicino.
SAPHO: What radiologists should know.
Clinical...