Cotten A, Flipo R M, Mentre A, Delaporte E, Duquesnoy B, Chastanet P
Department of Radiology, Hospital B, Centre Hospitalier Regional Universitaire de Lille, France.
Radiographics. 1995 Sep;15(5):1147-54. doi: 10.1148/radiographics.15.5.7501856.
Palmoplantar pustulosis and severe acne are sometimes associated with peculiar aseptic skeletal conditions, but such skeletal lesions can be found without skin lesions. The term SAPHO syndrome has been coined for this cluster of manifestations. (The acronym SAPHO refers to synovitis, acne, palmoplantar pustulosis, hyperostosis, and osteitis.) The most common site of the disease is the upper anterior chest wall, characterized by predominantly osteosclerotic lesions, hyperostosis, and arthritis of the adjacent joints. Osteosclerosis of the vertebral bodies, hyperostosis, and erosions of the vertebral plates can be encountered. Unilateral sacroiliitis is frequently observed. Long bone involvement consists of osteosclerosis or osteolysis with periosteal new bone formation. Peripheral arthritis can be present but is rarely associated with joint destruction. The pathogenesis of this syndrome remains unknown, but a link with seronegative spondyloarthropathies is probable. Radiologists should be aware of this unusual syndrome to avoid misdiagnosis (eg, tumor, infection), unnecessary surgery, and antibiotic therapy.
掌跖脓疱病和重度痤疮有时与特殊的无菌性骨骼疾病相关，但此类骨骼病变也可在无皮肤病变的情况下出现。“SAPHO综合征”这一术语被用来描述这一组临床表现。（首字母缩写词SAPHO指滑膜炎、痤疮、掌跖脓疱病、骨质增生和骨炎。）该病最常见的部位是前胸壁上部，其特征主要为骨硬化性病变、骨质增生以及相邻关节的关节炎。椎体骨硬化、骨质增生以及椎板侵蚀也可出现。单侧骶髂关节炎较为常见。长骨受累表现为骨硬化或骨质溶解并伴有骨膜新生骨形成。外周关节炎可能存在，但很少与关节破坏相关。该综合征的发病机制尚不清楚，但很可能与血清阴性脊柱关节病有关。放射科医生应了解这种不寻常的综合征，以避免误诊（如肿瘤、感染）、不必要的手术和抗生素治疗。
