SAPHO Syndrome: A case report

Abstract

SAPHO syndrome is a rare disease, and may lead to misdiagnosis of infectious osteomyelitis, resulting in long-term treatment with antibiotics, or osteoblastic metastasis when the patient have primary tumor history. We report a case of SAPHO syndrome who had a primary cancer history. The patient was a 42-year-old patient suffered from left breast cancer and received operation in 1997. Bone scintigraphy showed uptake at right sternoclavicular junction. She started to complained about anterior chest wall pain one year later. Series of bone scintigraphy from 1997 to 2003 showed progressive uptake at right sternoclavicular junction, spine, sacroiliac joint and the left sternoclavicular junction. The pain persisted and progressed, and pustular skin lesions over palms and soles also developed in 2003. CT scan and MRI study revealed multifocal peculiar hyperostotic bone lesions involving bilateral sternoclavicular junction, lumbar vertebra, and right sacroiliac joint, with mild degree surrounding marrow edema around the lesions. Base on her clinical history, serial chest films, hyperostosis, and pustular skin lesions, possibility of bone metastasis was excluded and a diagnosis of SAPHO syndrome was made.