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Vol. 13. Issue 1.
Pages 44-47 (January - February 2017)
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Vol. 13. Issue 1.
Pages 44-47 (January - February 2017)
Case report
DOI: 10.1016/j.reumae.2015.11.022
SAPHO Syndrome Presenting as an Osteolytic Lesion of the Neck
Lesión osteolítica cervical como presentación del síndrome SAPHO
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Lourdes Mateoa,
Corresponding author
lmateo.germanstrias@gencat.cat

Corresponding author.
, Juana Saninta, Samantha Rodríguez Muguruzaa, Melania Martínez Morilloa, Ricard Pérez Andrésb, Sira Domenech Puigcerverc
a Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
b Servicio de Radiodiagnóstico, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
c Unidad de Resonancia magnética (IDI), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
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Abstract

We report a case of acute-onset multifocal vertebral osteitis with a marked impact on the patient's general health. The radiological, scintigraphic and magnetic resonance findings made it necessary to carry out a differential diagnosis to distinguish it from an infiltrative neoplastic process and determine whether it had an infectious or an inflammatory etiology. The presence of noninfectious multifocal osteitis and sternoclavicular arthritis and the subsequent development of plantar pustulosis pointed to SAPHO syndrome. Treatment with infliximab led to improvement in the clinical symptoms, laboratory values and radiological abnormalities.

Keywords:
SAPHO
Psoriatic arthritis
Osteolytic lesions
Aseptic osteomyelitis
Multifocal vertebral osteomyelitis
Resumen

Se expone un caso de osteítis vertebral múltiple de presentación aguda con marcada afectación del estado general. Los hallazgos radiológicos, gammagráficos y de resonancia magnética obligaron al diagnóstico diferencial de un proceso neoplásico infiltrativo y de un origen infeccioso vertebral frente a la etiología inflamatoria. Por la presencia de osteítis múltiple no infecciosa, artritis esternoclavicular y la ulterior aparición de pustulosis plantar, se orientó como síndrome SAPHO. El tratamiento con infliximab consiguió la mejoría clínica, analítica y de las alteraciones radiológicas.

Palabras clave:
SAPHO
Artritis psoriásica
Lesiones osteolíticas
Osteomielitis aséptica
Osteomielitis vertebral múltiple

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