title: Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome presenting as a primary calvarial lesion. Case report and review of the literature.
abstract: The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a recently described, currently evolving clinical entity that groups together several idiopathic disorders of bone and skin formerly described under a variety of names. Among the spectrum of possible locations for the bone lesions, there is no previous report in the literature of primary involvement of the skull vault. A patient with primary involvement of the calvaria in the setting of SAPHO syndrome is described here, which, to the authors' knowledge, is the first report of such localization. The clinically and radiologically benign evolution of the different stages of the bone lesions is presented. The authors suggest that the SAPHO syndrome should be considered in the differential diagnosis of lytic, sclerotic, or hyperostotic lesions of the skull, particularly before considering invasive diagnostic procedures.
authors.affiliation: Department of Neurological Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA.
authors.forename: F
authors.initials: F
authors.lastname: DiMeco
authors.forename: R E
authors.initials: RE
authors.lastname: Clatterbuck
authors.forename: K W
authors.initials: KW
authors.lastname: Li
authors.forename: E F
authors.initials: EF
authors.lastname: McCarthy
authors.forename: A
authors.initials: A
authors.lastname: Olivi
mesh_terms: D020083:Acquired Hyperostosis Syndrome / Q000473:pathology*; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010000:Osteitis / Q000175:diagnosis / Q000473:pathology; D012886:Skull / Q000473:pathology*