Cases reported "Osteitis"

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1/25. Stress-induced SAPHO syndrome.

    We describe the case of a woman with the classic combination of features of synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome, including pustulosis palmo-plantaris and anterior chest wall involvement. The varying symptomology, etiology and pathogenesis of this syndrome and the contribution of stress are discussed. The authors ascribe the dearth of reported cases to lack of awareness and recognition of SAPHO, and not to the real incidence of the syndrome.
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keywords = hyperostosis
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2/25. The SAPHO syndrome in children: a rare cause of hyperostosis and osteitis.

    The SAPHO syndrome is a rare constellation of signs and symptoms characterized by synovitis, acne, pustulosis, hyperostosis, and osteitis. The most common musculoskeletal complaints are hyperostosis, causing pain, tenderness, and swelling of the anterior chest wall, although any part of the axial and appendicular skeleton may be affected. There is a great degree of variability in the dermatologic involvement of this syndrome. A combination of clinical, radiographic, and pathological investigation is required to establish the correct diagnosis. No single treatment has been found to be effective, although nonsteroidal antiinflammatory drugs have been the most frequently used. Because there is no mention of SAPHO syndrome in the English orthopaedic literature, and pediatric orthopaedic surgeons may be the first caregivers to treat these children, we thought it appropriate to share our experience with a 5-year-old boy with SAPHO syndrome recently under our care.
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ranking = 6
keywords = hyperostosis
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3/25. A case report of synovitis, acne, pustulosis, hyperostosis and osteitis syndrome presenting with spondylodiscitis.

    SAPHO syndrome stands for synovitis, acne, pustulosis, hyperostosis and osteitis. The common site of skeletal lesions in this syndrome is the sternocostoclavicular area. Spondylodiscitis is rarely described in published studies. In general, skin lesions develop before the onset of skeletal lesions. We report a case of SAPHO syndrome in which spondylodiscitis developed more than 1 year before the onset of pustulosis.
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ranking = 21.992607138681
keywords = sternocostoclavicular, hyperostosis
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4/25. synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome presenting as a primary calvarial lesion. Case report and review of the literature.

    The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a recently described, currently evolving clinical entity that groups together several idiopathic disorders of bone and skin formerly described under a variety of names. Among the spectrum of possible locations for the bone lesions, there is no previous report in the literature of primary involvement of the skull vault. A patient with primary involvement of the calvaria in the setting of SAPHO syndrome is described here, which, to the authors' knowledge, is the first report of such localization. The clinically and radiologically benign evolution of the different stages of the bone lesions is presented. The authors suggest that the SAPHO syndrome should be considered in the differential diagnosis of lytic, sclerotic, or hyperostotic lesions of the skull, particularly before considering invasive diagnostic procedures.
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ranking = 5
keywords = hyperostosis
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5/25. Spinal hyperostosis--a rare skeletal manifestation of psoriasis vulgaris.

    A 28-year-old woman with uncomplicated psoriasis vulgaris presented with spinal hyperostosis and osteitis. The absence of peripheral arthritis, sacroiliitis, and diffuse idiopathic skeletal hyperostosis (DISH) raised the possibility that the spinal lesion was an extracutaneous manifestation of psoriasis. We review the association between uncomplicated psoriasis vulgaris and skeletal involvement.
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ranking = 6
keywords = hyperostosis
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6/25. Noninfectious osteitis: part of the SAPHO syndrome.

    SAPHO, a rare syndrome, is a recently suggested acronym for synovitis, acne, pustulosis, hyperostosis and osteitis. It encompasses many features which have been described in different but overlapping conditions. Not all of the syndrome components need to be present for inclusion in SAPHO to be justified, especially the dermatologic components. Two cases are described as examples. Clinicians should be aware of this rare disorder if positive early diagnoses are to be made in patients presenting with skeletal pain.
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ranking = 1
keywords = hyperostosis
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7/25. hyperostosis and osteitis in Sapho syndrome: conservative or surgical treatment.

    Sapho syndrome is characterized by synovitis, acne, pustulosis, hyperostosis and osteitis. It is a rare disease, with a benign prognosis; at the osteoarticular level it is painful and is characterized by episodes of arthritis of an intermittent and at times disabling nature. The etiopathogenesis of Sapho syndrome is still not clearly defined: some authors suggest a probable correlation with an infective agent, others instead include Sapho among seronegative spondylites. The treatment of symptomatic skeletal injuries (hyperostosis, osteitis) is controversial and not classified. In the rare cases reported in the literature surgical treatment has not proven to be more effective than conservative treatment. The authors report the poor evolution of the disease in a patient affected with Sapho syndrome who came to our observation after being submitted to medullary decompression of the femoral diaphysis because of the presence of metaphyseal hyperostosis of the left femur.
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ranking = 3
keywords = hyperostosis
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8/25. Palmoplantar pustulotic arthro-osteitis of the peripheral joints with no sternocostoclavicular lesions.

    A 45 year old woman presented with swelling and pain on joint movement of her knees, although joint movement was relatively well maintained. Five years previously the patient had been diagnosed as having pustulosis palmoplantaris by a dermatologist. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) had no effect, but treatment with 5 mg/day prednisolone caused remission of both the joint pain and swelling and the pustulosis palmoplantaris. There were no sternocostoclavicular lesions at any time during treatment. Clinical findings in this patient were different from previous reports and she was diagnosed as having palmoplantar pustulotic arthro-osteitis affecting the peripheral joints.
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ranking = 84.963035693403
keywords = sternocostoclavicular
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9/25. case reports: aseptic femoral osteitis and sternocostal hyperostosis from SAPHO syndrome.

    synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome are characterized by peculiar bone lesions that commonly involve the anterior chest wall. osteitis typically is the most prominent skeletal lesion seen in synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome. We present a patient with aseptic femoral osteitis and sternocostal hyperostosis. The classic clinical, radiographic, and histologic features of this syndrome are described. diagnosis is difficult in patients with only one symptomatic bone. The lesion often is confused with suppurative osteomyelitis because of similar clinicopathologic findings. Although the optimal treatment is unclear, it is important to consider synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome in the differential diagnosis of any lytic, sclerotic, or hyperostotic bone lesion to avoid unnecessary long-term antibiotic therapy.
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ranking = 8
keywords = hyperostosis
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10/25. In SAPHO syndrome anti-TNF-alpha therapy may induce persistent amelioration of osteoarticular complaints, but may exacerbate cutaneous manifestations.

    OBJECTIVES: SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) is a rare disease combining skin, bone and joint manifestations. In recent years new therapeutic strategies have been tried, among them TNF-alpha-blocking agents. We report our experience with infliximab in four cases of SAPHO syndrome refractory to conventional therapies. methods: Between 2002 and 2005, four cases of SAPHO syndrome (two females and two males; mean age 49.7 yr) responding poorly to conventional drugs were treated with infliximab. The dose was 5 mg/kg, according to the protocol used in spondyloarthropathies, with infusions at 0, 2 and 6 weeks followed by 6 weeks intervals. No active cutaneous manifestations were present at the time of starting therapy. RESULTS: Complete remission of osteoarticular involvement was achieved after the second or third infusion, and the positive response was maintained for up to 12 months. A patient relapsed after discontinuation of infliximab, because of infectious complication. Palmoplantaris pustulosis relapsed in two patients after three and six infusions, respectively; there was slight improvement after discontinuation of anti-TNF-alpha drugs. CONCLUSIONS: Infliximab seems to be a very effective therapy for osteoarticular complaints of SAPHO syndrome. Cutaneous involvement responded less favourably, palmoplantaris pustulosis relapse being a possible complication.
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ranking = 1
keywords = hyperostosis
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