SAPHO and CRMO: The Value of Imaging

Area of Science:

• Rheumatology
• Radiology
• Dermatology

Background:

• Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) and chronic recurrent multifocal osteomyelitis (CRMO) are chronic inflammatory osteoarticular disorders.
• These conditions often present with skin manifestations like palmoplantar pustulosis and acne conglobata.
• SAPHO predominantly affects adults, while CRMO is more common in children and adolescents.

Purpose of the Study:

• To provide an overview of the radiologic appearances of SAPHO/CRMO.
• To highlight key pathogenetic, clinical, and pathologic features for diagnosis.
• To emphasize the importance of characteristic imaging in avoiding misdiagnosis.

Main Methods:

• Review of radiologic findings in SAPHO/CRMO.
• Correlation of imaging features with clinical and pathological data.
• Discussion of diagnostic challenges and interdisciplinary approaches.

Main Results:

• SAPHO/CRMO exhibit characteristic osteitis and/or hyperostosis on imaging.
• Imaging appearances vary based on patient age and lesion stage.
• Characteristic imaging can help distinguish SAPHO/CRMO from infection and tumors.

Conclusions:

• Radiologic assessment is crucial for diagnosing SAPHO/CRMO.
• Attention to specific imaging features can prevent misdiagnosis and unnecessary procedures.
• An interdisciplinary approach, including radiologists, is essential for accurate diagnosis and management.