Extended reports
Spondylodiscitis in SAPHO syndrome. A series of eight
cases
a University hospital J Minjoz, boulevard
Fleming, 25030 Besançon Cedex, France:
Department of Rheumatology , b Department of Internal
Medicine
Correspondence to: Pr D Wendling
Accepted for publication 16
September 1996
OBJECTIVE
To determine the frequency, clinical
features, and radiological and bone scintigraphic changes of
spondylodiscitis in patients with SAPHO (synov-itis, acne, pustulosis,
hyperostosis, and osteitis).
METHODSThe study was retrospective. Data from
patients with the diagnostic criteria of SAPHO syndrome were analysed
for clinical features, biological data (HLA B antigen), and pelvic and
spine x rays. Spine computed tomography (CT) or magnetic
resonance imaging (MRI) were also examined in some cases.
RESULTS25 patients with a diagnosis of SAPHO
were seen since 1985. Eight had spondylodiscitis. These included five
with palmoplantar pustulosis, one with pustular psoriasis, one with
psoriasis vulgaris, and one with chronic recurrent multifocal
osteomyelitis without skin disease. The skin lesion occurred before the
spondylodiscitis in four cases. Chest wall involvement was observed in
four cases and sacroiliac joint lesions only in the case with
osteomyelitis. HLA B27 was always negative and HLA B8 was found in four
cases. Radiological findings consisted of erosive or sclerosing
remodelling of endplates with a narrowed disc space; a reduced height
of the vertebral body was also observed in some cases. These spinal
lesions occurred in the three vertebral segments. Multiple sites of
spondylodiscitis in the same patient were common. Bone scan showed
mildly increased uptake and CT and MRI were useful for detecting signs
of infection such as abscess. Enhanced signals on T2 weighted sequence
or after injection of gadolinium were often observed. Follow up study
of most of these patients suggests that the prognosis of
spondylodiscitis in the SAPHO syndrome is favourable.
CONCLUSIONSDespite few description in the
literature, spondylodiscitis in the SAPHO syndrome is common (32% in
this series). These radiological findings are similar to the
discovertebral changes of spondylodiscitis in ankylosing spondylitis,
thus giving support to the relations between SAPHO syndrome and
spondyl-arthropathies. However, this does not mean that the pathogenic
mechanisms are the same in these two conditions.
© 1997 by Annals of the Rheumatic Diseases
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Hong, S. H., Choi, J.-Y., Lee, J. W., Kim, N. R., Choi, J.-A., Kang, H. S.
(2009). MR Imaging Assessment of the Spine: Infection or an Imitation?1. RadioGraphics
29: 599-612
[Abstract] [Full Text] -
Laredo, J.-D., Vuillemin-Bodaghi, V., Boutry, N., Cotten, A., Parlier-Cuau, C.
(2007). SAPHO Syndrome: MR Appearance of Vertebral Involvement. Radiology
242: 825-831
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Calcium and bone
-
Musculoskeletal syndromes
-
Bone and joint infections
-
Immunology (including allergy)
-
Clinical diagnostic tests
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
