SAPHO Syndrome as a Potential Cause of Chronic Mandibular Bone Inflammation and Temporomandibular Joint Dysfunction – Case Report

Abstract

SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis) is a rare disease, with an unknown, probably multifactor etiology, comprising osteoarticular disorders of aseptic inflammatory character, and cutaneous changes of massive acne or palmoplantar pustulosis type. Usually the changes involve the anterior thoracic wall, and sternoclavicular and sacroiliac joints. According to literature reports, the mandible is affected in 10% of cases. The paper presents a case of SAPHO syndrome in an 18-year-old patient, with the involvement of the right body, angle, and branch of the mandible and the right temporomandibular joint. Considering the results of imaging examinations (computed tomography, magnetic resonance, and scintigraphy), as well as laboratory, histopathological and microbiological investigations, the authors discuss the possible diagnostic problems and the differentiation of SAPHO syndrome with other diseases. The article also presents different treatment methods, including temporomandibular joint reconstruction with the use of an alloplastic prosthesis. The aim of the paper is to present SAPHO syndrome as a potential cause of primarily chronic mandibular bone inflammation and stomatognathic system dysfunction.