Bone Imaging in SAPHO Syndrome

The acronym SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) stands for a recently described syndrome of unknown cause and pathogenesis that may be related to the seronegative spondyloarthropathies. We present the case of a 17-year-old boy who reported lower limb pain that rendered him unable to walk. He was receiving isotretinoin to treat severe acne. There was no response to treatment with different analgesics (morphine, intravenous anesthetics), and the intensity and extension of the pain increased progressively, leaving him bedridden. SAPHO syndrome was diagnosed, and high-dose nonsteroid anti-inflammatory therapy was begun, resulting in a favorable outcome.