C1-C2 spondylodiscitis in an adult with SAPHO syndrome: an unusual presentation.
The main advantage of recognition and diagnosis of SAPHO syndrome is the avoidance of unnecessary prolonged antibiotic treatment and repeated invasive procedures. The combination of synovitis, acne, pustulosis, hyperostosis and aseptic osteitis is known as SAPHO syndrome. The most common site of the disease is the upper anterior chest wall, characterized by predominantly osteosclerotic lesions, hyperostosis, and arthritis of the adjacent joints. Osteosclerosis of the vertebral bodies, hyperostosis, and erosions of the vertebral plates are rarely encountered. We present a case of SAPHO syndrome with C1-C2 spondylodiscitis. Diagnosis of SAPHO syndrome was established using Khan et al. criteria (Schilling, SAPHO syndrome, Encyclopedie Orphanet, 2004). CT showed osteosclerotic lesions of dens axis. MRI sequences reveal inflammatory bone marrow oedema. Radiologists should be aware of this unusual syndrome to avoid misdiagnosis (tumour/infection), unnecessary surgery, and antibiotic therapy.
Harifi
Ghita
G
Service de Rhumatologie, CHU Mohamed VI, 40000 Marrakech, Morocco. ghitaharifi@yahoo.fr
Belkhou
Ahlam
A
El Bouchti
Imane
I
Ouali Idrissi
Meryem
M
Chérif Idrissi
Najat
N
Ousehal
Ahmed
A
El Hassani
Selma
S
D020083:Acquired Hyperostosis Syndrome / Q000150:complications* / Q000175:diagnosis; D000328:Adult; D001368:Axis, Cervical Vertebra / Q000473:pathology*; D001270:Cervical Atlas / Q000473:pathology*; D003937:Diagnosis, Differential; D015299:Discitis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology*; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male
D005682:Gadolinium