Hyperostosis of the Clavicle as a Cardinal Symptom for Sapho Syndrome – Presentation and Discussion of a Clinical Case

Abstract

SAPHO syndrome comprises a broad clinical spectrum and is based on inflammatory osteitis with or without association to a dermatological affection. A young man with chronic recurrent osteomyelitis (CRMO) of the right clavicle as a cardinal symptom of SAPHO syndrome is reported on. Whole-body MRI has proven effective for focal detection and assessment of local activity of a possible multifocal manifestation of CRMO. Multiple medication with NSAIDs, a bisphosphonate, vitamin D substitution and antibiosis resulted in extensive remission of symptoms. Biologicals can also be used if there is no effect. The terminology of chronic nonbacterial osteomyelitis (CNO) in connection with the SAPHO syndrome is discussed.

Zusammenfassung

Das SAPHO-Syndrom umfasst ein breites klinisches Spektrum und beruht auf einer entzündlichen Osteitis mit oder ohne Assoziation zu einer dermatologischen Affektion. Es wird über einen jungen Mann mit einer chronisch rekurrierenden Osteomyelitis (CRMO) der rechten Klavikula als ein Kardinalsymptom für das SAPHO-Syndrom berichtet. Zur Fokussuche und Beurteilung einer lokalen Aktivität einer möglichen multifokalen Manifestation der CRMO hat sich das Ganzkörper-MRT bewährt. Eine multifaktorielle Medikation mit NSAR, einem Bisphosphonat, einer Vitamin D Substitution und einer Antibiose führten zu einer weitgehenden Remission der Beschwerden. Biologika können bei einem ausbleibenden Effekt zusätzlich zum Einsatz kommen. Auf die Begrifflichkeit der chronischen nichtbakteriellen Osteomyelitis (CNO) im Zusammenhang mit dem SAPHO-Syndrom wird eingegangen.

Key words

Acne - chronic recurrent multifocal osteomyelitis - hyperostosis - SAPHO syndrome - synovitis

Schlüsselwörter

Akne - chronisch rekurrierende multifokale Osteomyelitis - Hyperostose - SAPHO-Syndrom - Synovitis

Publication History

Received: 25 June 2023

Accepted: 28 August 2023

Article published online:
06 October 2023

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