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Rheumatology Advance Access originally published online on July 16, 2003
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Rheumatology 2003; 42: 1398-1403
© 2003 British Society for Rheumatology

Diagnostic points and possible origin of osteomyelitis in synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome: a radiographic study of 77 mandibular osteomyelitis cases

Y. Suei, A. Taguchi and K. Tanimoto1

Department of Oral and Maxillofacial Radiology, Hiroshima University Dental Hospital and 1Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.

Correspondence to: Y. Suei, Department of Oral and Maxillofacial Radiology, Hiroshima University Dental Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8553, Japan. E-mail: suei{at}hiroshima-u.ac.jp

Objectives. To find diagnostic points and to identify the origin of osteomyelitis in synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome.

Methods. Fifty-two patients with mandibular suppurative osteomyelitis and 25 patients with mandibular osteomyelitis in SAPHO syndrome were included in the study. Radiographic patterns of the lesion, types of periosteal reaction and the presence of external bone resorption and bone enlargement were investigated in each case and compared between the two entities.

Results. Suppurative osteomyelitis demonstrated an osteolytic pattern and a lamellated type of periosteal reaction, whereas SAPHO syndrome revealed a mixed-pattern, solid-type periosteal reaction, external bone resorption and bone enlargement.

Conclusions. Radiographic examination is suggested to be convenient and a useful diagnostic method of differentiating osteomyelitis in SAPHO syndrome from suppurative osteomyelitis. The periosteum is suspected to be the original site of osteomyelitic lesions in SAPHO syndrome.

KEY WORDS: Radiology, Bone diseases, Hyperostosis, Bone resorption.


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