SAPHO syndrome

The acronym SAPHO represent the major findings of

• Synovitis
  • Medial clavicle and sternoclavicular joints → "Bull's head sign"
  • Spine
    • Contiguous involvement of ≥ 2 vertebral bodies
      • A curvilinear or semicircular pattern involving portions of adjacent vertebral bodies (sclerotic corner lesions, flowing hyperostosis)
      • Usually spare intervertebral discs
    • Subligamentous thickening
    • Paraspinal soft tissue involvement
• Acne (conglobata)
• Pustulosis (palmaris et plantaris)/ psoriasis
• Hyperostosis
  • Can be osteolytic early
  • Can be chunky, asymmetric, quiet aggressive looking
• Osteitis
  • The most common manifestation

The syndrome encompassed previously disorders like

• CNO / CRMO
• Pustulotic arthro-osteitis
• Palmoplantar pustolosis (PPP)
• Sternocostoclavicular hyperostosis