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Semin Musculoskelet Radiol 2018; 22(02): 207-224
DOI: 10.1055/s-0038-1639469
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

SAPHO and CRMO: The Value of Imaging

Anne Grethe Jurik
1   Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
2   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
Rikke Fuglsang Klicman
1   Department of Radiology, Aarhus University Hospital, Aarhus, Denmark
,
Paolo Simoni
3   Department of Radiology, Hôpital Universitaire des Enfants “Reine Fabiola,” Université Libre de Bruxelles, Brussels, Belgium
,
Philip Robinson
4   Department of Musculoskeletal Centre X-Ray, Musculoskeletal Biomedical Research Centre (BRC), Chapel Allerton Hospital, Leeds, United Kingdom
,
James Teh
5   Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom
› Author Affiliations
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Publication History

Publication Date:
19 April 2018 (online)

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Abstract

The syndromes synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) and chronic recurrent multifocal osteomyelitis (CRMO) constitute a group of chronic relapsing inflammatory osteoarticular disorders with frequently associated skin eruptions such as palmoplantar pustulosis and acne conglobata and rather characteristic imaging features in the form of osteitis and/or hyperostosis. CRMO predominantly occurs in children/adolescents and SAPHO in adults. Any skeletal site can be involved, and the imaging appearances vary, depending on the patient's age and the stage/age of the lesion. The diagnosis may be difficult if there is no skin disease, but attention to characteristic imaging appearances may help avoid misdiagnosis (e.g., infection and tumor) and thereby unnecessary invasive procedures as well as facilitating early diagnosis and appropriate treatment. This article provides an overview of the radiologic appearances of SAPHO/CRMO and relevant pathogenetic, clinical, and pathologic features to facilitate the diagnosis that often requires an interdisciplinary approach including radiologists.

Keywords

SAPHO - CRMO - osteitis - hyperostosis - spondyloarthritis