title: The SAPHO syndrome revisited with an emphasis on spinal manifestations.
abstract: The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome includes a group of chronic, relapsing, inflammatory musculoskeletal disorders with similar manifestations, in particular synovitis, hyperostosis, and osteitis, which may or may not be associated with neutrophilic skin eruptions such as palmoplantar pustulosis and acne conglobata. The syndrome occurs at any age, can involve any skeletal site, and its imaging appearances are variable, depending on the stage/age of the lesion and imaging method. The diagnosis is difficult if there is no skin disease. Awareness of the imaging appearances, especially in the spine, may help the radiologist in avoiding misdiagnosis (e.g., infection, tumor) and unnecessary invasive procedures, while facilitating early diagnosis and selection of an effective treatment. In this article, we provide an overview of the radiological appearances of SAPHO syndrome, focusing on the magnetic resonance imaging findings of vertebral involvement, and present relevant clinical and pathological features that assist early diagnosis.
authors.affiliation: Department of Radiological Sciences, Catholic University, School of Medicine, Largo A. Gemelli 1, 00168, Rome, Italy, a.leonemd@tiscali.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Leone
authors.forename: Victor N
authors.initials: VN
authors.lastname: Cassar-Pullicino
authors.forename: Roberto
authors.initials: R
authors.lastname: Casale
authors.forename: Nicola
authors.initials: N
authors.lastname: Magarelli
authors.forename: Alessia
authors.initials: A
authors.lastname: Semprini
authors.forename: Cesare
authors.initials: C
authors.lastname: Colosimo
mesh_terms: D020083:Acquired Hyperostosis Syndrome / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D013122:Spinal Diseases / Q000473:pathology*; D055815:Young Adult