title: Imaging for Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) Syndrome.
abstract: Multifocal osteomyelitis and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome constitute a spectrum of disease that includes inflammatory bone lesions and dermatologic findings. Radiographic features resemble those of the spondyloarthropathies with anterior chest wall involvement. Early radiographic findings are osteodestructive with lytic lesions. Bone scintigraphy of the sternoclavicular region classically yields a 'bull's head' pattern of radionuclide uptake. Magnetic resonance imaging (MRI) can demonstrate corner lesions of vertebral bodies. Ultrasound often reveals peripheral enthesitis. Late radiographic features are usually osteoproliferative. PET/CT can identify chronic lesions. Differential diagnostic considerations include osteomyelitis and malignancy, which often prompt bone biopsy.
authors.affiliation: Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA 01605, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Schaub
authors.affiliation: Division of Musculoskeletal Imaging, Department of Radiology, UMass Memorial Medical Center and University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
authors.forename: Hartley M
authors.initials: HM
authors.lastname: Sirkis
authors.affiliation: Division of Rheumatology, Department of Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, 119 Belmont Street, Worcester, MA 01605, USA. Electronic address: jonathan.kay@umassmemorial.org.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Kay
mesh_terms: D020083:Acquired Hyperostosis Syndrome / Q000000981:diagnostic imaging*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D006801:Humans; D007596:Joints / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D000072078:Positron Emission Tomography Computed Tomography; D011859:Radiography; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
keywords: Acne; CRMO; Hyperostosis; Osteitis; Palmoplantar pustulosis; SAPHO syndrome; Vertebral corner lesion; ‘Bull's head’ sign