Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Case 75 Intraosseous lipoma
- Case 76 Lipoma arborescens
- Case 77 Liposarcoma
- Case 78 Mazabraud syndrome
- Case 79 Neurofibromatosis type I (NF I)
- Case 80 Benign peripheral nerve sheath tumors (PNSTs)
- Case 81 Malignant peripheral nerve sheath tumors (MPNSTs)
- Case 82 Synovial sarcoma
- Case 83 Aggressive fibromatosis (desmoid tumor)
- Case 84 Chondrosarcoma
- Case 85 Pigmented villonodular synovitis (PVNS)
- Case 86 Synovial chondromatosis (osteochondromatosis)
- Case 87 Myositis ossificans
- Case 88 Aneurysmal bone cyst (ABC)
- Case 89 Soft tissue hemangioma
- Case 90 Giant cell tumor (GCT)
- Case 91 Ganglion cyst
- Case 92 Chondroblastoma
- Case 93 Hypertrophic osteoarthropathy
- Case 94 SAPHO syndrome
- Index
- References
Case 94 - SAPHO syndrome
from Section 12 - Tumors/Miscellaneous
Published online by Cambridge University Press: 05 July 2013
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Case 75 Intraosseous lipoma
- Case 76 Lipoma arborescens
- Case 77 Liposarcoma
- Case 78 Mazabraud syndrome
- Case 79 Neurofibromatosis type I (NF I)
- Case 80 Benign peripheral nerve sheath tumors (PNSTs)
- Case 81 Malignant peripheral nerve sheath tumors (MPNSTs)
- Case 82 Synovial sarcoma
- Case 83 Aggressive fibromatosis (desmoid tumor)
- Case 84 Chondrosarcoma
- Case 85 Pigmented villonodular synovitis (PVNS)
- Case 86 Synovial chondromatosis (osteochondromatosis)
- Case 87 Myositis ossificans
- Case 88 Aneurysmal bone cyst (ABC)
- Case 89 Soft tissue hemangioma
- Case 90 Giant cell tumor (GCT)
- Case 91 Ganglion cyst
- Case 92 Chondroblastoma
- Case 93 Hypertrophic osteoarthropathy
- Case 94 SAPHO syndrome
- Index
- References
Summary
Imaging description
In adults the most frequent site for the SAPHO syndrome is the sternoclavicular region (Figure 94.1). About 65–90% of patients show involvement of the sternoclavicular region. With time all the components of the anterior chest wall can become involved particularly the sternoclavicular, upper costosternal, costochondral, and manubriosternal junctions. Radiographically the most common feature is hyperostosis, characterized by chronic periosteal reaction and cortical thickening leading to bone hypertrophy (Figure 94.1). This may be associated with enthesopathy leading to ligamentous ossification, bony bridging, and joint ankylosis. Soft tissue edema and thickening may be seen adjacent to the involved bones and joint. When the disease is advanced these changes are readily identified by radiography, but early changes of sternoclavicular hyperostosis require the use of CT for a definitive diagnosis. CT and MRI may be required for detecting serious complications of sternoclavicular hyperostosis resulting from bony overgrowth which can lead to subclavian vein obstruction and superior vena cava syndrome.
On rare occasions extra-axial SAPHO can occur in the long bones (Figure 94.2), pelvis, scapula, and tarsal bones.
Bone scintigraphy is a sensitive technique for detecting SAPHO lesions throughout the skeleton in early stages of the disease (Figure 94.1 and Figure 94.2 A). The bull horn sign in the upper anterior chest wall is diagnostic of SAPHO.
Magnetic resonance imaging demonstrates the changes due to arthritis and the bone marrow edema. MRI can also be useful in the follow-up of patients to determine active from chronic inactive lesions.
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- Pearls and Pitfalls in Musculoskeletal ImagingVariants and Other Difficult Diagnoses, pp. 249 - 254Publisher: Cambridge University PressPrint publication year: 2013