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05:53
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
[Vertebral involvement in SAPHO syndrome]
1Service de radiologie ostéo-articulaire, Hôpital Lariboisière, AP-HP, 2 rue Ambroise Paré, 75475 Paris cedex, France. caroline.parlier@lrb.aphp.fr
Journal De Radiologie
|September 4, 2010
Summary
SAPHO syndrome presents diverse radiographic signs but stereotypical MRI findings of enthesopathy. Differentiating it from infections or tumors requires recognizing varying lesion ages and characteristic vertebral corner enthesopathy.
Area of Science:
- Rheumatology
- Radiology
- Orthopedics
Background:
- SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) exhibits varied radiographic findings.
- Radiographic features include sclerosing osteitis, ivory vertebra, and vertebral compression fractures.
Observation:
- MRI reveals stereotypical enthesopathy at the anterior vertebral corner, common in spondyloarthropathies.
- Enthesophytes can extend to vertebral endplates, cortex, or annulus, affecting adjacent vertebrae in 30% of cases.
- Intervertebral discs may show narrowing, intense T2W signal, and enhancement, mimicking spondylodiscitis.
Findings:
- Pseudo-infectious appearance is heightened by adjacent soft tissue masses in one-third of cases.
- Lesions can be challenging to distinguish from infectious spondylodiscitis or tumors.
- Key differential diagnostic feature: varying ages of lesions on adjacent vertebral segments with characteristic enthesopathy.
Implications:
- Understanding these MRI features is crucial for accurate diagnosis of SAPHO syndrome.
- Distinguishing SAPHO syndrome from mimics like infectious spondylodiscitis or tumors is vital for appropriate management.
- Characteristic enthesopathy aids in differentiating SAPHO syndrome from other spinal pathologies.
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