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Hu N, Liu J, Cui W, Wang J, Wang Z, Chen X. Extracutaneous/osteoarticular manifestations in patients with SAPHO syndrome. Int J Rheum Dis 2023; 26:1649-1652. [PMID: 37664960 DOI: 10.1111/1756-185x.14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 05/24/2023] [Accepted: 05/28/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Nandong Hu
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
| | - Jingjing Liu
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
- The First Clinical Institute, Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenjing Cui
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
| | - Jianhua Wang
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
| | - Zhongqiu Wang
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
| | - Xiao Chen
- Department of Radiology, The Affiliated Hospital of Nanjing, University of Chinese Medicine, Nanjing, China
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Yu M, Cao Y, Li J, Zhang Y, Ye Y, Wang L, Huang Z, Lu X, Li C, Huo J. Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings. Arthritis Res Ther 2020; 22:216. [PMID: 32928273 PMCID: PMC7491189 DOI: 10.1186/s13075-020-02309-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The anterior chest wall (ACW) involvement is characteristic of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, yet little research has focused on its magnetic resonance imaging (MRI) findings. PURPOSE To characterize the MRI features of the ACW in patients with SAPHO syndrome. METHODS Seventy-one patients with SAPHO syndrome and ACW involvement evidenced by bone scintigraphy were recruited in this cross-sectional study. The ACW region was scanned using sagittal, axial, and oblique coronal Dixon T2-weighted sequences and axial Dixon T1-weighted sequences. The characteristics of both active inflammatory and chronic structural lesions were evaluated. RESULTS The ACW lesions exhibited an asymmetrical distribution and a predilection for the sternocostoclavicular region (93.0%). Notably, 91.5% of the patients had lesions in the area of the anterior first ribs. Bone marrow edema (BME) was observed in 63 (88.7%) patients, which mainly affected the sternocostal joints (87.3%) and the manubrium sterni (84.5%). All of the BMEs were distributed under the articular surface or the bone cortex, consistent with the distribution of the ligaments and joint capsules. Synovitis was detected in 64 (90.1%) patients, with a predilection for the sternoclavicular joints (76.1%). A soft tissue mass or infiltration was found in all the patients who had bone marrow edema. Thirteen (18.3%) patients showed venous stenosis. Structural changes included bone bridge formation (80.3%), hyperostosis (43.7%), and fat infiltration (39.4%). Four common patterns of involvement were observed: the first rib area, the sternoclavicular area, the sternal angle area, and the areas of the second to sixth sternocostal joints. CONCLUSION The ACW lesions of SAPHO syndrome demonstrated a triad of enthesitis, synovitis, and osteitis, suggesting complex interactions among the ligaments, synovium, and bones in the region. The inflammatory changes in the first rib area were highlighted in SAPHO syndrome.
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Affiliation(s)
- Meiyan Yu
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Mei Shu Guan Hou Street, Beijing, 100010, China
| | - Yihan Cao
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Junqiu Li
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Mei Shu Guan Hou Street, Beijing, 100010, China
| | - Yanan Zhang
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Mei Shu Guan Hou Street, Beijing, 100010, China
| | - Yuqian Ye
- Institute of Clinical Medicine, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Lun Wang
- Institute of Clinical Medicine, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Ziwei Huang
- School of Traditional Chinese Medicine, Beijing University of Traditional Chinese Medicine, Beijing, 100029, China
| | - Xinyu Lu
- Institute of Clinical Medicine, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Chen Li
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1, Shuai Fu Yuan, Beijing, 100730, China.
| | - Jianwei Huo
- Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Mei Shu Guan Hou Street, Beijing, 100010, China.
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Liu S, Tang M, Cao Y, Li C. Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: review and update. Ther Adv Musculoskelet Dis 2020; 12:1759720X20912865. [PMID: 32523634 PMCID: PMC7236399 DOI: 10.1177/1759720x20912865] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 02/23/2020] [Indexed: 12/15/2022] Open
Abstract
Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a spectrum of heterogeneous diseases characterized by osteoarticular and dermatological manifestations. Osteitis and hyperostosis are core clinical manifestations in SAPHO syndrome, typically affecting multiple areas and possibly progressing to irreversible osteoarticular damage. Most patients with SAPHO have cutaneous involvement, mainly manifested as palmoplantar pustulosis and severe acne. Systemic manifestations are uncommon but occasionally reported. Epidemiological studies suggest the annual prevalence of SAPHO syndrome varies from 0.00144 in 100,000 in Japanese individuals to fewer than 1 in 10,000 in White individuals. The precise etiopathogenesis of SAPHO remains unclear, but it is generally considered an autoinflammatory syndrome that may be related to various etiologies, such as immune dysfunction, infection and genetic predisposition. Owing to the relapsing-remitting disease course, the goal of management is to improve clinical symptoms and prevent disease progression. Various treatments, including nonsteroidal anti-inflammatory drugs, conventional disease-modifying antirheumatic drugs, bisphosphonates, biologics, and antibiotics, are promising options for alleviating the disease.
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Affiliation(s)
- Shuang Liu
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Mingwei Tang
- Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yihan Cao
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Chen Li
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.9 Dong Dan San Tiao, Beijing 100730, China
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Godot A, Fakih O, Prati C, Wendling D, Verhoeven F. SAPHO syndrome and subclavian thrombosis: Simple fortuitous association? Eur J Intern Med 2020; 72:103-105. [PMID: 31796244 DOI: 10.1016/j.ejim.2019.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Amélie Godot
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France
| | - Olivier Fakih
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France
| | - Clément Prati
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France; EA 4267 "PEPITE", University of Bourgogne Franche-Comté, 25000 Besancon, France
| | - Daniel Wendling
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France; EA4266 "EPILAB" University of Bourgogne Franche-Comté, 25000 Besancon, France
| | - Frank Verhoeven
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France; EA 4267 "PEPITE", University of Bourgogne Franche-Comté, 25000 Besancon, France.
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