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Rheumatology Advance Access published online on July 16, 2003
Rheumatology, doi:10.1093/rheumatology/keg396
Rheumatology © British Society for Rheumatology 2003; all rights reserved
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© 2003 Rheumatology 42 © British Society for Rheumatology 2003; all rights reserved

Original Papers

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 1*, A. Taguchi 1, and K. Tanimoto 2

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

* Corresponding author. E-mail: suei{at}hiroshima-u.ac.jp.

Received 24 December 2002 ; accepted 3 April 2003

Abstract

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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