FDG PET Helpful for Diagnosing SAPHO Syndrome

Kohlfuerst, Susanne; Igerc, I.; Lind, P

doi:10.1097/01.rlu.0000090943.11941.26

Cited by 16 publications

(10 citation statements)

References 7 publications

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“…Although the radiographic features of SAPHO syndrome are very characteristic, sometimes a biopsy is necessary. Recently, reports have indicated that [ 18 F] FDG-PET is useful in distinguishing SAPHO syndrome from tumors [7][8][9]. In our case, the recent history of tuberculous lymphadenitis and MRI findings of destructive spondylodiscitis firmly supported a diagnosis of tuberculous spondylitis.…”

Section: Discussionsupporting

confidence: 66%

A case of SAPHO syndrome with destructive spondylodiscitis suspicious of tuberculous spondylitis

et al. 2009

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We report a rare case of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome in which the differential diagnosis included tuberculous spondylitis and the patient ultimately required reconstructive spinal surgery. The patient was a 60-year-old woman who presented with severe low-back and leg pain after treatment for tuberculosis. Roentgenography and magnetic resonance imaging of the lumbar spine revealed destructive changes suggestive of tuberculous spondylitis. [(18)F]-fluoro-2-deoxyglucose positron emission tomography/computed tomography showed uptake in the cervical spines, lumbar spines, and sacroiliac joints from which she was suspected of having SAPHO syndrome without skin manifestations. However, as her symptoms did not respond to conservative treatment, we performed reconstructive surgery of the lumbar spine. Spinal specimens obtained surgically showed nonspecific inflammation and fibrous hypertrophy of the bone marrow, confirming a diagnosis of the SAPHO syndrome. Her symptoms improved markedly after surgery, although she required occasional prednisolone for moderate polyarthralgia and leg pain.

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Section: Discussionsupporting

confidence: 66%

A case of SAPHO syndrome with destructive spondylodiscitis suspicious of tuberculous spondylitis

et al. 2009

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“…Recently, several case reports have shown the utility of 18 FDG-PET in distinguishing active infl ammatory lesions from chronic sclerotic lesions in the SAPHO syndrome. Both lesions show augmented accumulation in static bone scintigraphy using 99m Tc-labeled diphosphonate, but 18 FDG-PET shows increased uptake only in lesions with active infl ammation [5,6]. A few case reports have shown that 18 FDG-PET is effective in distinguishing active infl ammatory lesions of the SAPHO syndrome from metastatic bone tumors as well as healed chronic infl ammatory lesions [13,14].…”

Section: Discussionmentioning

confidence: 91%

“…The vertebral spine is a frequently involved site of the disease, and magnetic resonance imaging (MRI) has been shown to be useful to better delineate the extent of the infl ammatory process [4]. Positron emission tomography (PET) using F-18 fl uorodeoxyglucose ( 18 FDG) has also been reported to be useful in depicting active infl ammatory lesions [5,6]. With the ability to merge functional and anatomic information, improvements in diagnostic accuracies for cancers using hybrid 18 FDG-PET/CT over its individual components have been established [7].…”

Section: Introductionmentioning

confidence: 98%

Diagnosing active inflammation in the SAPHO syndrome using 18FDG-PET/CT in suspected metastatic vertebral bone tumors

Inoue

Yamaguchi²,

Ozawa

et al. 2007

Ann Nucl Med

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The vertebral spine is frequently affected by the SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome. We report the collective imaging findings of hybrid F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT), as well as bone scans and magnetic resonance imaging, in a patient who had suspected metastatic vertebral bone tumors. 18FDG-PET/CT can be utilized to exclude metastatic vertebral tumors, as well as identifying stable lesions, by demonstrating active inflammatory lesions with accurate anatomic localization through the convergence of the functional information from 18FDG uptake with the anatomic information of CT.

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“…Currently, whole-body bone scintigraphy and MRI are commonly used, which allows for early diagnosis and higher sensitivity compared with conventional radiographic imaging [ 3 , 9 ]. The use of F-18 fluorodeoxyglucose-positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in SAPHO has been described by several case reports [ 10 – 21 ] (Table 1 ) and has been demonstrated to be effective in excluding metastatic disease in challenging cases and differentiating active lesions from inactive lesions [ 22 ]. However, few studies on the value of PET/CT in SAPHO syndrome have been performed in relatively large population.…”

Section: Introductionmentioning

confidence: 99%

F-18 FDG PET/CT in 26 patients with SAPHO syndrome: a new vision of clinical and bone scintigraphy correlation

Sun

Cao

et al. 2018

J Orthop Surg Res

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BackgroundsWhole-body bone scintigraphy (WBBS) and MRI are widely used in assessment of patients with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. However, the value of F-18 fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) in SAPHO syndrome was unclear. The aim of this study was to characterize the manifestation of SAPHO syndrome on 18F-FDG PET/CT and explore its relationship with clinical symptoms and WBBS.MethodsTwenty-six patients who suffered from SAPHO syndrome and had undergone whole-body 18F-FDG PET/CT were recruited in Peking Union Medical College Hospital from 2004 to 2016. Clinical manifestations and laboratory findings were recorded for all patients. Imaging data on 18F-FDG PET/CT and WBBS were collected and analyzed retrospectively.ResultsAll the 26 patients (20 females and 6 males) exhibited skeletal abnormalities on 18F-FDG PET/CT. Multiple skeletal lesions affecting the anterior chest wall or spine with low to moderate 18F-FDG uptake and coexistence of osteolysis and osteosclerosis presented as the typical features of SAPHO syndrome. Sixteen (61.5%) patients had abnormal 18F-FDG uptake outside the osteoarticular system. PET scan had moderate to substantial agreement with CT and WBBS in revealing lesions in the anterior chest wall and axial skeleton. Nonetheless, the correlation between increased 18F-FDG uptake and clinical symptoms was weak.ConclusionsSAPHO syndrome exhibits characteristic features on 18F-FDG PET/CT. It showed comparable capacity in revealing skeletal lesions with bone scintigraphy.Electronic supplementary materialThe online version of this article (10.1186/s13018-018-0795-0) contains supplementary material, which is available to authorized users.

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FDG PET Helpful for Diagnosing SAPHO Syndrome

Cited by 16 publications

References 7 publications

A case of SAPHO syndrome with destructive spondylodiscitis suspicious of tuberculous spondylitis

A case of SAPHO syndrome with destructive spondylodiscitis suspicious of tuberculous spondylitis

Diagnosing active inflammation in the SAPHO syndrome using 18FDG-PET/CT in suspected metastatic vertebral bone tumors

F-18 FDG PET/CT in 26 patients with SAPHO syndrome: a new vision of clinical and bone scintigraphy correlation

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