Clinical and Radiological Identification and Management of SAPHO Syndrome

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an autoinflammatory disease whose acronymic name stands for the symptoms commonly seen in the disease. These symptoms typically occur simultaneously, in different combinations, in patients during exacerbations of the disease. SAPHO syndrome is a rare disease, most frequently seen in patients aged 30 to 50. It is estimated to be found in 1 in 10 000 persons in White populations, with an even lower incidence seen in non-White populations.

A post-menopausal woman with a medical history of SAPHO presented to the emergency department with left foot pain and chest pain with palpitation. She had chronic pustular rashes, located on the bilateral soles of the feet, bilateral palms, neck, and abdomen, which she stated appeared hours after the initial presentation of her pain. Chest X-ray readings showed osteitis and sclerosis of the sternocostoclavicular joint and first rib, a radiological finding of SAPHO syndrome. The patient was successfully treated with nonsteroidal anti-inflammatory drugs for pain relief and IV corticosteroids for the rheumatoid-like inflammatory aspect of SAPHO.

While SAPHO syndrome is a rare disease, it is important to be aware of its manifestations and symptoms, such as the patient's rash, foot and chest pain, in addition to the dermatological symptoms appearing simultaneously. An early diagnosis can provide patients with accurate and appropriate treatment.