SAPHO syndrome

A 63-year-old man suffered with incomplete fracture of ribs due to a 1-day history of chest trauma. He reported having palmoplantar pustulosis and intermittent upper chest pain for 12 years. Multiple ecchymosis and desquamation were shown in both palmar and plantar regions (Fig. 1A). Computed tomographic three-dimensional reconstruction of the bones of the anterior chest wall (Fig. 1B) showed hyperostosis and fusion of the first costosternal and manubriosternal joints, forming the bull’s head sign (blue arrows). Computed tomography of the dorsal spine in the sagittal plane showed sclerosis, hyperostosis and erosion of the vertebral plates D7-10. The patient was diagnosed with SAPHO syndrome. SAPHO syndrome refers to synovitis, acne, palmoplantar pustulosis, hyperostosis and osteitis, which usually affects the anterosuperior chest wall [1]. Treatment options include non-steroidal anti-inflammatory drugs, corticosteroids, bisphosphonates, colchicine, and immunosuppressive or biological agents in refractory cases [2]. All authors...