title: Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome: a single centre study of a cohort of 164 patients.
abstract: The aim was to assess the clinical, laboratory and radiological features of SAPHO syndrome.
  
  
  
  We recruited all patients presenting to Peking Union Medical College Hospital from 2004 to 2015 diagnosed with SAPHO syndrome. The medical data, laboratory test results and imaging were collected for all patients.
  
  
  
  One hundred and sixty-four patients (111 women and 53 men) were recruited to our cohort. The mean age of the patients was 40.71 years. Nine patients had osteoarticular symptoms without skin involvement. One hundred and forty-three and 25 patients had palmoplantar pustulosis and severe acne, respectively. Psoriasis vulgaris was accompanied by palmoplantar pustulosis or severe acne in 24 patients. One hundred and sixty-four patients suffered from pain in the anterior chest wall, followed by spine (12 in the cervical region, 36 in the thoracic region and 111 in the lumbosacral region) and peripheral joint (136 patients) involvement. None of the patients had IBD. The hs-CRP level was increased in 70.8% patients. Only 2.4% were HLA-B27 positive. CT scan indicated osteolysis, sclerosis and hyperostosis in the anterior chest wall and spine in SAPHO syndrome patients. The bull-horn sign was the typical characteristic of SAPHO syndrome seen in bone scintigraphy images. One hundred and thirty-one (79.9%), 85 (51.8%), 100 (61%) and 54 (32.9%) patients took NSAIDs, CSs, DMARDs and oral bisphosphonates, respectively.
  
  
  
  SAPHO syndrome is predominant in middle-age women, characterized by dermatological and osteoarticular manifestations with unknown aetiology. CT scan and bone scintigraphy are useful for diagnosis. There is still no standard treatment to control the disease.
authors.affiliation: Department of Traditional Chinese Medicine.
authors.forename: Chen
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Orthopedic Surgery.
authors.forename: Yuzhi
authors.initials: Y
authors.lastname: Zuo
authors.affiliation: Department of Orthopedic Surgery.
authors.forename: Nan
authors.initials: N
authors.lastname: Wu
authors.affiliation: Department of Dermatology.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Dermatology.
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Radiology.
authors.forename: Weihong
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Radiology.
authors.forename: Wenrui
authors.initials: W
authors.lastname: Xu
authors.affiliation: Department of Radiology.
authors.forename: Xue
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Nuclear Medicine.
authors.forename: Hongli
authors.initials: H
authors.lastname: Jing
authors.affiliation: Department of Nuclear Medicine.
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Pan
authors.affiliation: Department of Pathology.
authors.forename: Weixun
authors.initials: W
authors.lastname: Zhou
authors.affiliation: Department of Pathology.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Orthopedic Surgery.
authors.forename: Yu
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of Orthopedic Surgery.
authors.forename: Jianyi
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery.
authors.forename: Sen
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Orthopedic Surgery.
authors.forename: Zhenlei
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences.
authors.forename: Fengchun
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Zeng
authors.affiliation: Department of Immunology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, State Key Laboratory of Medical Molecular Biology and.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Immunology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, State Key Laboratory of Medical Molecular Biology and.
authors.forename: Siya
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Traditional Chinese Medicine.
authors.forename: Jinhe
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Orthopedic Surgery.
authors.forename: Guixing
authors.initials: G
authors.lastname: Qiu
authors.affiliation: Department of Orthopedic Surgery, Department of Central Laboratory, Beijing Key Laboratory for Genetic Research of Skeletal Deformity, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P.R. China.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Traditional Chinese Medicine.
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: Dong
authors.affiliation: Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, zhangwen91@sina.com.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
mesh_terms: D020083:Acquired Hyperostosis Syndrome / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D001842:Bone and Bones / Q000000981:diagnostic imaging; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D015796:HLA-B27 Antigen / Q000097:blood; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging / Q000379:methods; D014057:Tomography, X-Ray Computed
chemical_list: D015796:HLA-B27 Antigen; D002097:C-Reactive Protein
keywords: SAPHO syndrome; clinic and radiologic features; treatment