SAPHO (synovitis-acne-pustulosis-hyperostosis-osteitis): a multidisciplinary approach.
OBJECTIVE
The aim of this study is to suggest a model for inquiry and treatment of patients with undiagnosed multiple inflammatory reactions.


METHODS
A retrospective study was performed using 43 patient records from patients with chronic osteomyelitis of the jaw, treated at the Oral and Maxillofacial Clinic at Södersjukhuset, Stockholm, Sweden. The diagnoses primary chronic osteomyelitis (PCO) or secondary chronic osteomyelitis (SCO) were eventually made, according to symptoms and course of disease.


RESULTS
A total of 85% of the PCO patients fulfilled the criteria of the disorder SAPHO (synovitis-acne-pustulosis-hyperostosis-osteitis). The difficulty of settling on the diagnosis, as well as the length and diversity of treatment, was extreme. After treatments became multidisciplinary, time between diagnosis and cure was halved.


CONCLUSIONS
In order to improve diagnostics and treatment of patients with chronic inflammatory disease of the jaw, a structured plan for examination and treatment is proposed.
Consultant, former Head of Department, Clinic of Oral and Maxillofacial Surgery at Södersjukhuset, Stockholm, Sweden. Electronic address: karin.wannfors@gmail.com.
Karin
K
Wannfors
D020083:Acquired Hyperostosis Syndrome / Q000175:diagnosis* / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007571:Jaw Diseases / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome