SAPHO-Syndrom

Depression in

patients with SAPHO syndrome and its relationship with brain activity and connectivity. A 50-year-old woman with SAPHO syndrome presented with recurrent palmoplantar pustulosis for seven years and multiple joint pain for six years. (a) Erythema with pustules and scales on the right foot. (b) Coronal CT image of sternoclavicular joints demonstrates hyperostosis and erosive changes

SAPHO

syndrome • SAPHO syndrome - Ganzer Fall bei Radiopaedia

SAPHO

syndrome • SAPHO syndrome - Ganzer Fall bei Radiopaedia

SAPHO

syndrome • SAPHO syndrome - Ganzer Fall bei Radiopaedia

Anterior

chest wall in SAPHO syndrome: magnetic resonance imaging findings. Active inflammatory lesions in the ACW shown by oblique coronal (a–c, e–n, p) and axial (d, o) water-only T2W Dixon images in patients with SAPHO syndrome. a Extended BME in the bilateral sternoclavicular region, resembling the “bull’s head” sign. b BME of the sternocostoclavicular region. c BME of the sternocostoclavicular region and the sternal angle. d BME of the ossified bones in the first left rib and the first right SCoJ. e Active inflammatory changes of the surrounding tissue of the first right rib and the first right SCoJ. f Active inflammatory changes of the right costoclavicular ligament area and the first right SCoJ. g BME of the medial end of the left clavicle. h BME of the medial ends of the bilateral clavicles. i BME and hyperostosis of the medial end of the right clavicle. j Active inflammatory changes of the left costoclavicular ligament area and the SClJ. k BME of the sternal angle. l Pseudowidening of the SClJ. m BME of the bilateral SClJs with pseudowidening of joint space and BME of the right side of the sternal angle. n Joint effusion in the bilateral second and third SCoJ. o Joint effusion in the bilateral first SCoJ and soft tissue mass behind the manubrium sterni. p Soft tissue infiltration in the chest wall. Lesions are indicated by red arrows. BME, bone marrow edema; SCoJ, sternocostal joint; SClJ, sternoclavicular joint

Anterior

chest wall in SAPHO syndrome: magnetic resonance imaging findings. Chronic lesions in the ACW shown by oblique coronal (a–c) and sagittal (d, e) T2W Dixon images in patients with SAPHO syndrome. a Fat-only T2W Dixon image shows different shapes of fat infiltration, such as crescent in the corners of the manubrium, sheet in the right clavicle, and scattered lesions in the left clavicle. b Fat-only T2W Dixon image shows ossification of the costoclavicular ligament. c Fat-only T2W Dixon image shows a bone bridge of the sternal angle. d Fat-only T2W Dixon image shows hyperostosis in the sternal angle. Lesions are indicated by red arrows

SAPHO—a

diagnosis to consider in patients with refractory costochondritis. Axial CT image of thorax showing hypertrophy of the manubrium and irregularities, fusion on edges of manubriosternal and bilateral sternoclavicular joints. Arthropathy with ankylosis at bilateral sternoclavicular joints. Also, a section through the right sternoclavicular joint reveals osteolysis (→) and hyperostosis (▼)

SAPHO—a

diagnosis to consider in patients with refractory costochondritis. A 99mTc bone scintigram demonstrating the “bullhead sign” due to tracer uptake in the manubrium sterni, sternoclavicular joints and adjacent clavicles

Anterior

chest wall in SAPHO syndrome: magnetic resonance imaging findings. Soft tissue mass in the ACW region. a Sagittal water-only T2W Dixon image shows a soft tissue mass or infiltration around the hyperostotic bones in a 55-year-old female with a disease duration of 60 months. The lower part of the superior vena cava was normal, but the right brachiocephalic vein behind the soft tissue mass was slightly narrowed (red arrow). b Axial water-only T2W Dixon image reveals a soft tissue mass or infiltration behind the manubrium sterni in a 49-year-old male with a disease duration of 6 months. The left brachiocephalic vein was surrounded by the soft tissue mass and could not be evaluated (red arrow)

SAPHO

syndrome • SAPHO syndrome - Ganzer Fall bei Radiopaedia

SAPHO

syndrome with pathological fractures of vertebral bodies: a case report. Axial MRI scans of the sacroiliac joints illustrated inflammatory bone changes at the right sacroiliac joint that were hypointense on the T1-weighted image (a) and hyperintense on the T2-weighted image (b)

SAPHO

syndrome • SAPHO syndrome - Ganzer Fall bei Radiopaedia

Anterior

chest wall in SAPHO syndrome: magnetic resonance imaging findings. Lesions of the first costal cartilage in a 43-year-old female with SAPHO syndrome. a Axial fat-only T2W Dixon image shows irregular hyperintensity in the ossified bones in the right first costal cartilage, indicating fat infiltration. b Axial water-only T2W Dixon image shows irregular ossification beneath the perichondrium of the bilateral first costal cartilage and hyperintensity in the surrounding soft tissue, indicating inflammation. Lesions are indicated by red arrows

SAPHO

syndrome with pathological fractures of vertebral bodies: a case report. MRI scans of the thoracic showed superior end plate compression deformity in the T4 (b) and T8–11 vertebral bodies (a). In addition, diffused inflammatory bone changes were also noted in the T4 (b), T8–11(a) and L2 (c) vertebral bodies that were hypointense on the T1-weighted image (a) and hyperintense on the T2-weighted image (b)

Anterior

chest wall in SAPHO syndrome: magnetic resonance imaging findings. Distribution of bone marrow edema and edema of the surrounding soft tissue in the ACW region in patients with SAPHO syndrome. a The first rib lesion without involvement of the first SCoJ or the medial end of the clavicle. b The first SCoJ lesion. c Lesions in the costoclavicular ligament area with involvement of the medial end of the clavicle. d Lesions in the medial end of the clavicle adjacent to the manubrium without involvement of the adjacent sternoclavicular joint. e The SClJ lesion. f The sternal angle lesion. g Lesions in the second to sixth SCoJ. h The four common patterns of involvement: (I) the first rib area, possibly developing from the anterior end of the first rib (type A) to the first SCoJ (type B) and the costoclavicular ligament (type C); (II) the sternoclavicular area, involving the SClJ (type E), the medial end of the clavicle (type D), and the interclavicular ligament; (III) the sternal angle area (type F); and (IV) the areas of the second to sixth SCoJs (type G). BME, bone marrow edema; SCoJ, sternocostal joint; SClJ, sternoclavicular joint

SAPHO

syndrome with pathological fractures of vertebral bodies: a case report. SPECT/CT imaging of thoracic and lumbar revealed marginal erosions and superior endplate compression deformity in the T8–11 vertebral bodies. a: SPECT imaging; b: CT imaging; c: Fusion imaging

SAPHO

syndrome with pathological fractures of vertebral bodies: a case report. The WBS showed diffuse intense uptake at the proximal end of the right clavicle and seventh anterior rib, manubrium sterni, right sacroiliac joint, pubic symphysis and in the T8–11 thoracic vertebral bodies duo to inflammatory bone changes

SAPHO

syndrome with pathological fractures of vertebral bodies: a case report. CT scans of the thoracic and lumbar spine revealed erosions, hyperostosis, and osteosclerosis in the T8–11 and L2 vertebral bodies and fractures in the T8–11 vertebral bodies (a). The cortical bone of the sternum and sternoclavicular joint was continuous without damage (b)

SAPHO

syndrome: the supposed trigger by isotretinoin, the efficacy of adalimumab and the specter of depressive disorder: a case report. MRI STIR images of lumbar osteitis and sacroiliac involvement before (upside) and after ADA treatment (downside)

Spinal

disorders mimicking infection. 47-year-old male presenting with inflammatory back pain. Sagittal T1 (a) and R1 point 12 T2 (b)-WI show erosive L4-L5 endplates (arrow) associated on Sagittal STIR sequence (c) to a disc hypersignal (arrow) and on sagittal (d) and axial (e) T1 Fat Sat WI enhanced sequences to an enhancement of vertebral bodies and surrounding tissues as epidural fat space without abscess (star). Axial CT (f) on lumbar spine shows erosive pattern of vertebra (arrow) and Oblique reformatted CT (g) of anterior chest shows involvement with sclerotic lesions typical of SAPHO disease (star)