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I. SAPHO Syndrome
- SAPHO syndrome is a term that describes the association between inflammation of bones and joints, and acne or pustulosis:
II. Diagnostic Criteria
- Characteristic pustules or acne in the presence of sterile synovitis, hyperostosis, or osteitis
- Sterile synovitis, hyperostosis, or osteitis involving the axial or peripheral skeleton (anterior chest wall, vertebral bodies, sacroiliac joints) with or without characteristic skin lesions
III. Bone and Joint Manifestations
- Joint space loss
- Hyperostosis - "excessive osteogenesis" - may narrow or obliterate the medullary cavity and enlarge the surface of the bone
- Endosteal surface
- Medullary cavity
- Periosteal surface
- Osteitis is inflammation of the bone; clinically the bone is painful and tender
- Pustular psoriasis
- Palmoplantar pustulosis
- Variable elevation of serum markers
- Biopsy sometimes shows Propionibacterium acnes
- Nonsteroidal anti-inflammatory agents
- Often, no response with antibiotics
Boutin RD, Resnick D. The SAPHO syndrome: An evolving concept for unifying several disorders of bone and skin. Amer J Roentgen. 1998; 170:585-591.
Case of the Month
The patient is a white man aged 58 years who is newly referred to a rheumatology practice for ongoing management of his osteoarthritis...
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