Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis (SAPHO) Syndrome: Clinical and Therapeutic Aspects

Abstract

Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare entity. It is frequently underdetected. We report the case of SAPHO syndrome in a 38-year-old woman, seen in consultation for pain and swelling of the anterior chest wall affecting the sternoclavicular and sternocostal joints predominantly on the right, and low back pain with an inflammatory appearance with peripheral damage, especially in the legs. We also found in our patient episodes of palmoplantar pustulosis. The diagnosis of SAPHO syndrome was retained in accordance with Kahn's diagnostic criteria, and the osteitis was confirmed by morphological examinations (CT scan, MRI, and bone scintigraphy). The patient was treated with non-steroidal antiinflammatory drugs and methotrexate with good clinical improvement.

SAPHO Syndrome in Crohn’s Disease Successfully Treated with Ustekinumab: Case Report and Review of the Literature

“…Although SAPHO syndrome was initially considered to be a seronegative spondyloarthropathy, recent evidence suggests that it may be better described as primary inflammatory osteitis, within the spectrum of autoinflammatory diseases. [13][14][15] The onset of the disease varies from infancy to late adulthood, with an average age between 30-40 years. The main clinical features are osteitis and hyperostosis, which typically involve the anterior chest wall (in particular sternocostal joints, sternoclavicular joints, and the costoclavicular ligament), followed by the axial skeleton, the long bones of the extremities, the irregular bones (such as mandible), and the peripheral joints.…”

SAPHO Syndrome in Crohn’s Disease Successfully Treated with Ustekinumab: Case Report and Review of the Literature

“…Although SAPHO syndrome was initially considered to be a seronegative spondyloarthropathy, recent evidence suggests that it may be better described as primary inflammatory osteitis, within the spectrum of autoinflammatory diseases. [13][14][15] The onset of the disease varies from infancy to late adulthood, with an average age between 30-40 years. The main clinical features are osteitis and hyperostosis, which typically involve the anterior chest wall (in particular sternocostal joints, sternoclavicular joints, and the costoclavicular ligament), followed by the axial skeleton, the long bones of the extremities, the irregular bones (such as mandible), and the peripheral joints.…”