title: [SAPHO syndrome--clinical features].
abstract: OBJECTIVE
  Presentation of clinical features of the SAPHO syndrome.
  
  
  METHODS
  Seventeen patients (15 women and 2 men) with confirmed diagnosis of the SAPHO syndrome was presented. The culture of biopsy of pustulotic skin lesions was performed in 11 patients. ESR, C-reactive protein level and Waaler-Rose test were determined in all patients, and antinuclear antibodies and bone scintigraphy were performed in 16 patients. X-ray of the sterno-clavicular joints was performed in 15 patients.
  
  
  RESULTS
  The age of patients was 22-59 yr. (mean: 47.1 yr). The duration of joint symptoms was 0.1-25 yr. (mean: 4.4 years). Pustulosis was presented in 16 patients, only 1 patient had acne. All patients suffered from pain localized on the anterior chest wall. Tenderness of the peripheral joints: wrist (in 7 patients), shoulder (in 7 patients), knee (in 4 patients) was shown. In 6 patients, skin changes preceded joint symptoms, in 2 patients skin changes followed joint symptoms after 5 and 10 yr., respectively. All patients had negative the Waaler-Rose test. Active inflammatory process characterized by an increased ESR and C-reactive protein level was present in 12 patients. Abnormalities in x-ray of the sterno-clavicular joints were present in 4 patients. Characteristic alternations for the SAPHO syndrome in scintigraphic picture of the skeleton were observed in 14 patients. All patients were treated with non-steroidal anti-inflammatory drugs. In 8 patients, treatment with antibiotics, in 11 patients--with sulfasalazine, in 3 patients--with methotrexate and low doses of glucocorticosteroids, in 1 patient--with colchicines was performed.
  
  
  CONCLUSIONS
  Association of typical skin changes with pain of the anterior chest wall is the key for diagnosis of the SAPHO syndrome. It seems that this syndrome is more common in Poland than it has been previously estimated.
authors.affiliation: Klinika Reumatologii Pomorskiej Akademii Medycznej w Szczecinie.
authors.forename: Hanna
authors.initials: H
authors.lastname: Przepiera-Bedzak
authors.forename: Iwona
authors.initials: I
authors.lastname: Brzosko
authors.forename: Jacek
authors.initials: J
authors.lastname: Fliciński
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Samborski
authors.forename: Marek
authors.initials: M
authors.lastname: Brzosko
mesh_terms: D020083:Acquired Hyperostosis Syndrome / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging
chemical_list: D000974:Antibodies, Antinuclear; D002097:C-Reactive Protein