SAPHO Syndrome: Imaging Findings of Vertebral Involvement

Area of Science:

• Radiology
• Rheumatology
• Orthopedics

Background:

• Imaging findings in Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) syndrome are often misdiagnosed.
• This can lead to invasive procedures and delayed diagnosis.

Purpose of the Study:

• To evaluate the prevalence of a distinctive semicircular morphology in vertebral imaging of SAPHO syndrome patients.
• To improve diagnostic accuracy for SAPHO syndrome involving the spine.

Main Methods:

• Retrospective review of 18 patients with SAPHO syndrome and spine involvement.
• Descriptive analysis of various imaging modalities (MR, CT, radiography, bone scan, PET).

Main Results:

• A semicircular or curvilinear pattern of vertebral involvement was observed in 63% of patients.
• Contiguous involvement of multiple vertebral bodies was common (89%).
• Absence of intervertebral disc edema and enhancement was noted in most cases.

Conclusions:

• A semicircular pattern of vertebral involvement suggests SAPHO syndrome.
• SAPHO should be considered in the differential diagnosis for patients with this imaging pattern, especially when disc edema is absent.