The SAPHO syndrome is an acronym that refers to a rare condition that is manifested by a combined occurrence of 2
It classically tends to present in young to middle-aged adults. Presentation in the pediatric population is not uncommon.
SAPHO and related conditions have three stages of progression, which are described as:
- costoclavicular ligament ossification
- arthropathy of the sternoclavicular joint, osteitis of the medial end of the clavicle, first rib and sternum as well as hypertrophy of the costal cartilages
- osteitis, hyperostosis and hypertrophy of the medial ends of the clavicles, sternum and upper ribs and ultimately ankylosis
Plain radiograph is non-specific, but SAPHO syndrome can be suspected if present with the other clinical findings:
- sternoclavicular joint: most common location of involvement, with osteitis and hyperostosis
- osteosclerosis of vertebral bodies
- long bones: metaphyseal osteosclerosis and osteolysis 5
Treatment and prognosis
Tends to be benign although patients may have recurrent bouts of attacks. Pamidronate therapy has been successfully trialled for symptom relief (especially in the pediatric population) 6.
History and etymology
Chamot et al. initially described it in 1987 3.
- 1. Restrepo CS, Martinez S, Lemos DF et-al. Imaging appearances of the sternum and sternoclavicular joints. Radiographics. 29 (3): 839-59. doi:10.1148/rg.293055136 - Pubmed citation
- 2. Laredo JD, Vuillemin-bodaghi V, Boutry N et-al. SAPHO syndrome: MR appearance of vertebral involvement. Radiology. 2007;242 (3): 825-31. doi:10.1148/radiol.2423051222 - Pubmed citation
- 3. Boutin RD, Resnick D. The SAPHO syndrome: an evolving concept for unifying several idiopathic disorders of bone and skin. AJR Am J Roentgenol. 1998;170 (3): 585-91. AJR Am J Roentgenol (citation) - Pubmed citation
- 4. Azouz EM, Jurik AG, Bernard C. Sternocostoclavicular hyperostosis in children: a report of eight cases. AJR Am J Roentgenol. 1998;171 (2): 461-6. AJR Am J Roentgenol (abstract) - Pubmed citation
- 5. Cotten A, Flipo RM, Mentre A et-al. SAPHO syndrome. Radiographics. 1995;15 (5): 1147-54. Radiographics (abstract) - Pubmed citation
- 6. Kerrison C, Davidson JE, Cleary AG et-al. Pamidronate in the treatment of childhood SAPHO syndrome. Rheumatology (Oxford). 2004;43 (10): 1246-51. doi:10.1093/rheumatology/keh295 - Pubmed citation6
- 7. Sweeney SA, Kumar VA, Tayar J et-al. Case 181: Synovitis Acne Pustulosis Hyperostosis Osteitis (SAPHO) Syndrome. Radiology. 2012;263 (2): 613-7. doi:10.1148/radiol.12101436 - Pubmed citation