Intra-Articular Glucocorticosteroid Injection into Sternocostoclavicular Joints in Patients with SAPHO Syndrome

Pyoderma gangrenosum and its syndromic forms: evidence for a link with autoinflammation

“…To date, no randomized controlled clinical trials have been conducted to evaluate the efficacy of individual therapeutic modalities. Intra‐articular or systemic corticosteroids are effective in the majority of patients . Disease‐modifying antirheumatic drugs such as methotrexate, sulfasalazine, ciclosporin and leflunomide have been widely used, giving variable results .…”

“…Intra-articular or systemic corticosteroids are effective in the majority of patients. 68 Disease-modifying antirheumatic drugs such as methotrexate, sulfasalazine, ciclosporin and leflunomide have been widely used, giving variable results. 54,69 Considering the hypothesized role of P. acnes in the pathogenesis of SAPHO syndrome, antibiotic treatment, in particular with doxycycline, can be another treatment option.…”

Palmoplantar pustules and osteoarticular pain in a 42-year-old woman

“…Second-line agents include bisphophonates 23 , methotrexate 24 and TNF-α antagonists 11, 25 . Antimicrobials 26 and oral or intra-articular corticosteroids have been used with mixed results 27 . A recent case series demonstrated clinical response in 5 of 6 SAPHO patients within one month of IL-1 inhibition with anakinra, two of whom were refractory to TNF blockers 28 .…”

Sonographically Guided Sternoclavicular Joint Injection

“…Consequently, practitioners have used computed tomographic and fluoroscopic guidance to aspirate and inject the SCJ with good clinical outcomes and no major complications 17 , 18 , 21 . More recently, the use of sonography has been reported for SCJ aspiration and injection, but a formal technical description and validation of the sonographically guided SCJ injection technique is lacking 6 , 16 . Further exploration of sonographically guided SCJ injection techniques is warranted, as sonography provides several advantages over computed tomography and fluoroscopy, including portability, lack of ionizing radiation, and exquisite soft tissue imaging 22 , 23 .…”

“…Diagnostic SCJ injections may be used to confirm the SCJ as a pain generator, and therapeutic corticosteroid injections can reduce symptoms in cases of SCJ pain. 2,6,[16][17][18] Given the fact that SCJ disorders are uncommon, it is probable that many clinicians have not had substantial training or experience injecting the SCJ. 19 This lack of experience, combined with the complex and frequently distorted SCJ anatomy, may translate into poor injection accuracy.…”