Summary:
The authors present the case-report of a patient where after 7 years of the disease duration,
examinations and treatments in different departments, finally in the Institute of Rheumatology the
diagnosis of the SAPHO syndrome was established. During the past two months another two patients
with this syndrome were encountered. The acronym SAPHO symbolizes the main components of
this disease – synovitis, acne, pustulosis, hyperostosis and osteitis. Synovitis is manifested as
oligoarthritis, can affect any joint of the peripheral and axial skeleton, it has a tendency to attack
in particular joints and articulations of the anterior thoracic wall. Osteitis is a s a rule oligofocal but
can be also multifocal: it affects in particular epiphyses of bones and the spine. The position is similar
as regards periostitis. Dermatosis is represented by some form of acne (A. pustulosa, A . conglobata,
and A. fulminans) or psoriasis (P. vulgaris, P. pustulosa). The disease, due to some features, is close
to spondylarthritis (oligoarthritis, affection of the spine incl. possible syndesmophytes, absence of
RF). It is however not associated with HLA B-27. Specific treatment is not known, the prognosis
quoad vitam is favourable, the course is however usually chronic and can make the patie nt’s life
difficult. The differential diagnosis is important as it can be easily mistaken for osteomyelitis or
bone tumours.
Key words:
SAPHO, osteitis, osteomyelitis, acne, pustulosis, hyperostosis
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