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• Clinical Article •
Analysis of the use of MRI and CT in the diagnosis of SAPHO syndrome
TAN Huaqing  BAO Haihua  CAO Yuntai  XIA Hongjing  FU Shihan 

Cite this article as: TAN H Q, BAO H H, CAO Y T, et al. Analysis of the use of MRI and CT in the diagnosis of SAPHO syndrome[J]. Chin J Magn Reson Imaging, 2023, 14(11): 108-112. DOI:10.12015/issn.1674-8034.2023.11.018.


[Abstract] Objective To investigate the relationship between duration of illness and sternal stalk hypertrophy in patients with synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome and to analyze their imaging features.Materials and Methods Imaging and clinical data of 24 patients with SAPHO syndrome diagnosed in our hospital from January 2021 to September 2022 were retrospectively analyzed. CT and MRI were performed on axial skeletal involvement, including the anterior thorax, spine, and sacroiliac joints. The patients' disease duration was classified as ≤5 years and >5 years, divided into 14 cases and 10 cases. Measurements of the sternal stalk were made on chest CT images to explore the relationship between the duration of the disease and the hypertrophy of the sternal stalk.Results The sites of involvement in 24 patients included the anterior chest wall, spine and sacroiliac joints. The main types of lesions included osteosclerosis, bone erosion, bone marrow edema, and fat deposition. The incidence of osteosclerosis and bone erosion lesions in the anterior chest wall was higher than that in the spine, and the difference was statistically significant (P=0.017, P=0.030), and the incidence of fat deposition lesions in the spine was higher than that in the anterior chest wall and sacroiliac joints, and the difference was statistically significant (P=0.001, P=0.017). Patients with a disease duration of >5 years had higher rates of sternal stalk thickness and sternoclavicular joint involvement than those with a disease duration of ≤5 years, and the difference was statistically significant (P=0.023, P=0.020). The changes in sternal stem width (r2=0.003, P=0.815) and sternal stem thickness (r2=0.035, P=0.379) were not correlated with the course of the disease.Conclusions The types of lesions in SAPHO syndrome are complex, with osteosclerotic and bony erosive lesions being more prevalent in the anterior chest wall and fat deposition lesions being more common in the spine. A long course of the disease is more likely to lead to a change of sternal stalk thickness, and the involvement of the sternoclavicular joint may be a sign of a long course of disease.
[Keywords] SAPHO syndrome；axial skeletal lesions；palmoplantar pustulosis；computed tomography；magnetic resonance imaging

TAN Huaqing1   BAO Haihua1*   CAO Yuntai1   XIA Hongjing1   FU Shihan2  

1 Imaging Center, Affiliated Hospital of Qinghai University, Xining 810000, China

2 CT Department, Qinghai Provincial People's Hospital, Xining 810000, China

Corresponding author: BAO H H, E-mail: baohelen2@sina.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Qinghai Province "Kunlun Talents-High-end Innovation and Entrepreneurship Talents" Program [No. Qing Rencai Zi (2021) 13]; Qinghai Province Science and Technology Program (No. 2023-ZJ-918M).
Received  2023-04-23
Accepted  2023-10-27
DOI: 10.12015/issn.1674-8034.2023.11.018
Cite this article as: TAN H Q, BAO H H, CAO Y T, et al. Analysis of the use of MRI and CT in the diagnosis of SAPHO syndrome[J]. Chin J Magn Reson Imaging, 2023, 14(11): 108-112. DOI:10.12015/issn.1674-8034.2023.11.018.

[1]
NGUYEN M T, BORCHERS A, SELMI C, et al. The SAPHO syndrome[J]. Semin Arthritis Rheum, 2012, 42(3): 254-265. DOI: 10.1016/j.semarthrit.2012.05.006.
[2]
CHEN W, ITO T, LIN S H, et al. Does SAPHO syndrome exist in dermatology?[J]. J Eur Acad Dermatol Venereol, 2022, 36(9): 1501-1506. DOI: 10.1111/jdv.18172.
[3]
ZHANG L H, HAN S B, SONG L, et al. Comparative analysis and differentiation between SAPHO syndrome and spondyloarthropathies using whole-spine MRI[J/OL]. Clin Radiol, 2021, 76(5): 394.e9-394394.e14 [2023-04-22]. https://doi.org/10.1016/j.crad.2020.12.005. DOI: 10.1016/j.crad.2020.12.005.
[4]
YU M Y, CAO Y H, LI J Q, et al. Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings[J/OL]. Arthritis Res Ther, 2020, 22(1): 216 [2023-04-22]. https://doi.org/10.1186/s13075-020-02309-6. DOI: 10.1186/s13075-020-02309-6.
[5]
SUN X C, LI C, CAO Y H, et al. F-18 FDG PET/CT in 26 patients with SAPHO syndrome: a new vision of clinical and bone scintigraphy correlation[J/OL]. J Orthop Surg Res, 2018, 13(1): 120 [2023-04-22]. https://doi.org/10.1186/s13018-018-0795-0. DOI: 10.1186/s13018-018-0795-0.
[6]
ZHANG Y N, HUO J W, WEN Q X, et al. Analyses of misdiagnosis and missed diagnosis in patients with SAPHO syndrome[J]. Radiol Pract, 2019, 34(1): 55-59. DOI: 10.13609/j.cnki.1000-0313.2019.01.011.
[7]
FURER V, KISHIMOTO M, TSUJI S, et al. The diagnosis and treatment of adult patients with SAPHO syndrome: controversies revealed in a multidisciplinary international survey of physicians[J]. Rheumatol Ther, 2020, 7(4): 883-891. DOI: 10.1007/s40744-020-00235-2.
[8]
DAOUSSIS D, KONSTANTOPOULOU G, KRANIOTIS P, et al. Biologics in SAPHO syndrome: A systematic review[J]. Semin Arthritis Rheum, 2019, 48(4): 618-625. DOI: 10.1016/j.semarthrit.2018.04.003.
[9]
VEKIC D A, WOODS J, LIN P, et al. SAPHO syndrome associated with hidradenitis suppurativa and pyoderma gangrenosum successfully treated with adalimumab and methotrexate: a case report and review of the literature[J]. Int J Dermatol, 2018, 57(1): 10-18. DOI: 10.1111/ijd.13740.
[10]
BIUDEN S, MAATALLAH K, RIAHI H, et al. SAPHO syndrome mimicking infectious spondylodiscitis and bone metastasis[J/OL]. Case Rep Rheumatol, 2021, 2021: 5577257 [2023-04-22]. https://doi.org/10.1155/2021/5577257. DOI: 10.1155/2021/5577257.
[11]
CIANCI F, ZOLI A, GREMESE E, et al. Clinical heterogeneity of SAPHO syndrome: challenging diagnose and treatment[J]. Clin Rheumatol, 2017, 36(9): 2151-2158. DOI: 10.1007/s10067-017-3751-1.
[12]
PRZEPIERA-BĘDZAK H, BRZOSKO M. Clinical symptoms, imaging, and treatment of SAPHO syndrome: a single-center study of 52 cases[J]. Pol Arch Intern Med, 2018, 128(6): 396-399. DOI: 10.20452/pamw.4261.
[13]
JI Q, WANG Q, PAN W P, et al. Exceptional response of skin symptoms to secukinumab treatment in a patient with SAPHO syndrome: Case report and literature review[J/OL]. Medicine, 2022, 101(33): e30065 [2023-04-22].https://doi.org/10.1097/MD.0000000000030065. DOI: 10.1097/MD.0000000000030065.
[14]
HIROSAWA T, KATSUKURA S, SHIMIZU T. SAPHO syndrome[J/OL]. Am J Med Sci, 2020, 359(1): e5-e6 [2023-04-22]. https://doi.org/10.1016/j.amjms.2019.07.010. DOI: 10.1016/j.amjms.2019.07.010.
[15]
GAO S, DENG X L, ZHANG L H, et al. The comparison analysis of clinical and radiological features in SAPHO syndrome[J]. Clin Rheumatol, 2021, 40(1): 349-357. DOI: 10.1007/s10067-020-05187-0.
[16]
FURER V, KISHIMOTO M, TOMITA T, et al. Pro and contra: is synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) a spondyloarthritis variant?[J]. Curr Opin Rheumatol, 2022, 34(4): 209-217. DOI: 10.1097/BOR.0000000000000884.
[17]
RAMAUTAR A I, APPELMAN-DIJKSTRA N M, LAKERVELD S, et al. Chronic nonbacterial osteomyelitis of the sternocostoclavicular region in adults: a single-center Dutch cohort study[J/OL]. JBMR Plus, 2021, 5(5): e10490 [2023-04-22]. https://doi.org/10.1002/jbm4.10490. DOI: 10.1002/jbm4.10490.
[18]
LIU S, TANG M W, CAO Y H, et al. Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: review and update[J/OL]. Ther Adv Musculoskelet Dis, 2020, 12: 1759720X20912865 [2023-04-22]. https://doi.org/10.1177/1759720X2091286. DOI: 10.1177/1759720X20912865.
[19]
RUAN D D, WANG R L, HU Y N, et al. Clinical and imaging features of six Han patients with SAPHO syndrome[J/OL]. Acta Radiol, 2022: 2841851221142783 [2023-04-22]. https://doi.org/10.1177/02841851221142783. DOI: 10.1177/02841851221142783.
[20]
HATTORI K, TAKAHASHI N, SUZUKI M, et al. A case of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome with isolated lesions of the thoracic spine[J]. Mod Rheumatol Case Rep, 2023, 7(1): 243-246. DOI: 10.1093/mrcr/rxac030.
[21]
CAO Y H, LI C, YANG Q, et al. Three patterns of osteoarticular involvement in SAPHO syndrome: a cluster analysis based on whole body bone scintigraphy of 157 patients[J]. Rheumatology, 2019, 58(6): 1047-1055. DOI: 10.1093/rheumatology/key415.
[22]
HUANG H, ZHANG Z L, ZHAO J, et al. The effectiveness of treatments for patients with SAPHO syndrome: a follow-up study of 24 cases from a single center and review of literature[J]. Clin Rheumatol, 2021, 40(3): 1131-1139. DOI: 10.1007/s10067-020-05322-x.
[23]
KORYLLOU A, MEJBRI M, THEODOROPOULOU K, et al. Chronic nonbacterial osteomyelitis in children[J/OL]. Children, 2021, 8(7): 551 [2023-04-22]. https://doi.org/10.3390/children8070551. DOI: 10.3390/children8070551.
[24]
YU M Y, REN M M, HUO J W, et al. The whole-spine CT findings in SAPHO syndrome[J]. Comput Tomogr Theory Appl, 2021, 30(4): 503-510. DOI: 10.15953/j.1004-4140.2021.30.04.11.
[25]
GREENWOOD S, LEONE A, CASSAR-PULLICINO V N. SAPHO and recurrent multifocal osteomyelitis[J]. Radiol Clin North Am, 2017, 55(5): 1035-1053. DOI: 10.1016/j.rcl.2017.04.009.
[26]
JURIK A G, KLICMAN R F, SIMONI P, et al. SAPHO and CRMO: the value of imaging[J]. Semin Musculoskelet Radiol, 2018, 22(2): 207-224. DOI: 10.1055/s-0038-1639469.

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