My Orthopedic Surgery

Our patient's presentation is consistent with the syndrome known as SAPHO (synovitis, acne, pustulosis, hyperostosis and osteomyelitis), and formerly termed acne arthritis. The syndrome is characterized by severe scarring acne and related conditions; hyperostotic bone lesions (particularly in the clavicles and sternum); sacroiliitis; spondylitis; and, peripheral inflammatory arthritis.

This search was more productive than a search for Acquired Hyperostosis Syndrome but did find a lot of dermatological material

Search String "Acquired Hyperostosis Syndrome"[MAJR] URL http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&term=%22Acquired+Hyperostosis+Syndrome%22%5BMAJR%5D 111 articles Nov 2006

SAPHO Syndrome At A Glance SAPHO syndrome is a chronic disorder that involves the skin, bone, and joints. SAPHO is an eponym for the combination of synovitis, acne, pustulosis, hyperostosis, and osteitis. Some researchers feel that the SAPHO syndrome is related to the group of arthritis conditions which typically affect the spine, called the spondyloarthropathies. Treatment of SAPHO syndrome typically involves medications which reduce inflammation.

Review by Prof. Fritz Schilling Definition - SAPHO syndrome is a disease combining osseaous and articular manifestations associated with skin manifestations. Three diagnostic criteria characterize SAPHO sydrome: 1. multifocal osteitis with or without skin manifestations 2. Sterile acute or chronic joint inflammation associateted with either pustules or psoriasis of thepalms and soles, or acne, or hidradenitis 3. Sterile osteitis in the presence of either psoriasis or acne One of these criteria is sufficient for the diagnosis of SAPHO

Abstract A middle aged man presented with a 4 year history of painful swelling of both knees and pustular acne on his back. The MRI scan of the knees showed gross synovitis, so did the histopathology of the synovium. A diagnosis of SAPHO syndrome was made and he was treated with IV pamidronate. His pain reduced and acne completely cleared up on therapy. A dermatologist has rarely made a diagnosis of SAPHO syndrome and treated it. Indian Journal of Dermatology Venerology and Leprology 2005

Definition Synovitis Acne -- commonly involving the face and upper back. Pustulosis -- usually involving the palms of the hands and/or soles of the feet (palmo-plantar pustulosis). Hyperostosis Osteitis SAPHO syndrome is thought to comprise a spectrum of disorders that share some clinical, radiologic and pathologic characteristics. An entity known as chronic recurrent multifocal osteomyelitis (CRMO) was first described in 1972. Subsequently in 1978 several cases of CRMO were associated with clinical findings of palmoplantar pustulosis. Since then, a number of associations between skin conditions and osteoarticular disorders have been reported with a variety of different names including sternocostoclavicular hyperostosis, pustulotic arthro-osteitis, and acne-associated spondyloarthropathy. SAPHO was coined in 1987 and basically represents a spectrum of inflammatory osteitis which may or may not be associated with dermatologic pathology. Diagnostic Radiology/Musculoskeletal Imaging/Infection/SAPHO Syndrome From Wikibooks, the open-content textbooks collection

SAPHO syndrome is thought to comprise a spectrum of disorders that share some clinical, radiologic and pathologic characteristics. An entity known as chronic recurrent multifocal osteomyelitis (CRMO) was first described in 1972. Subsequently in 1978 several cases of CRMO were associated with clinical findings of palmoplantar pustulosis. Since then, a number of associations between skin conditions and osteoarticular disorders have been reported with a variety of different names including sternocostoclavicular hyperostosis, pustulotic arthro-osteitis, and acne-associated spondyloarthropathy. SAPHO was coined in 1987 and basically represents a spectrum of inflammatory osteitis which may or may not be associated with dermatologic pathology. Definition Synovitis Acne -- commonly involving the face and upper back. Pustulosis -- usually involving the palms of the hands and/or soles of the feet (palmo-plantar pustulosis). Hyperostosis Osteitis

A gentleman comes in complaining of right knee pain. He is a 48-year-old African American man who was transferred from the Infectious Disease Clinic to the Thayer Medical Service for possible septic arthritis. His symptoms essentially limited his right knee motion; he is not able to flex more than 30 degrees. He has had surgery. There is an area medial to the knee that is swollen, and there is an area lateral to the knee that has been draining pus since August 2005. He has some occasional chills, no fevers, and no other systemic manifestations.