The challenging diagnosis of synovitis–acne–pustulosis–hyperostosis–osteitis (SAPHO) syndrome: A rare case report

Abstract

Considered rare, the synovitis–acne–pustulosis–hyperostosis–osteitis (SAPHO) syndrome is a distinct clinical entity, associating skin manifestations and osteoarticular symptoms. Anterior chest wall pain centered at sternoclavicular and sternocostal joints is an important and characteristic clinical finding that can lead to its diagnosis. Radiologists and clinicians must be aware of synovitis–acne–pustulosis–hyperostosis–osteitis syndrome as it can mimic some of the more common disease entities such as Paget’s disease. We report the case of a 63-year-old male patient, with no significant medical history, who presented to the dermatology department, with severe palmar and plantar pustulosis associated with polyarthralgia. Computerized tomography scan showed sternoclavicular hyperostosis, in favor of SAPHO syndrome, with regression of clinical symptoms after non-steroidal anti-inflammatory drug treatment.