SAPHO syndrome with a pathological fracture of clavicle: a case report

Abstract

Background Synovitis-acne-pustulosis-hyperostosis-osteomyelitis (SAPHO) syndrome is a rare disease characterized by combined osteoarticular and cutaneous manifestations. The diagnosis of SAPHO syndrome remains difficult due to its clinical heterogeneity and often requires the identification of infectious neoplasm and other bone abnormalities. Surgical treatment of pathological fractures caused by SAPHO syndrome is extremely rare. We report the first surgical case of a pathological clavicle fracture with SAPHO syndrome. Case presentation: A 53-year-old male patient came to our Orthopedic Surgery Department in 2022, complaining of right shoulder pain for 4 months, aggravated with activity limitation for 3 days. And the patient presented with cutaneous lesions on the right upper extremity. Based on the clinical manifestations, imaging findings, bone scintigraphy findings and bone puncture pathology, the diagnosis of SAPHO syndrome was made. Notably, the patient also suffered pathological fracture of the ipsilateral clavicle. We treated the clavicle with open reduction and internal fixation and found satisfactory results at the subsequent 6-month follow-up. Conclusions This case shows the efficacy and safety of open reduction and internal fixation in the treatment of pathological fractures caused by SAPHO syndrome. We hope to provide valuable information regarding the treatment of SAPHO syndrome in this case which makes clinical data more comprehensive.