Hyperostosis of the Clavicle as a Cardinal Symptom for Sapho Syndrome – Presentation and Discussion of a Clinical Case

Abstract

SAPHO syndrome comprises a broad clinical spectrum and is based on inflammatory osteitis with or without association to a dermatological affection. A young man with chronic recurrent osteomyelitis (CRMO) of the right clavicle as a cardinal symptom of SAPHO syndrome is reported on. Whole-body MRI has proven effective for focal detection and assessment of local activity of a possible multifocal manifestation of CRMO. Multiple medication with NSAIDs, a bisphosphonate, vitamin D substitution and antibiosis resulted in extensive remission of symptoms. Biologicals can also be used if there is no effect. The terminology of chronic nonbacterial osteomyelitis (CNO) in connection with the SAPHO syndrome is discussed.