SAPHO Syndrome: Imaging findings of vertebral involvement

A. M. McGauvran, A. L. Kotsenas, F. E. Diehn, J. T. Wald, Carrie Carr, J. M. Morris

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE: Imaging findings in patients with a combination of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) are often misinterpreted as discitis/osteomyelitis or metastases, resulting in multiple biopsies and delayed diagnosis. We have incidentally noted a semicircular morphology in vertebral body imaging in several cases of SAPHO syndrome with vertebral involvement. Our goal was to evaluate the prevalence of this distinctive morphology in these patients. MATERIALSANDMETHODS: A retrospective review of patients with SAPHO syndrome diagnosed between July 1998 and August 2013 was conducted. A descriptive analysis of MR imaging, CT, radiography, bone scanning, and PET imaging was performed for the presence and distribution of vertebral body signal intensity or attenuation changes and/or enhancement; contiguous vertebral body involvement; vertebral body collapse; endplate irregularity; disc space, facet, and spinous process involvement; subligamentous thickening; and paraspinal soft-Tissue involvement. RESULTS: Eighteen patients (16 women [89%]; mean age, 52.9 years) with SAPHO and spine involvement were included. Contiguous involvement of ≥2 vertebral bodies was found in 16 patients (89%), with a curvilinear or "semicircular" pattern involving portions of adjacent vertebral bodies in 10 (63%, P = .14). Most intervertebral discs demonstrated absence of abnormal T2 hyperintensity (73%) and enhancement (89%). Subligamentous thickening was present in 12 (67%). Paraspinal soft-Tissue involvement was present in 6 (33%). CONCLUSIONS: SAPHO syndrome should be included in the differential diagnosis in a patient with a curvilinear or semicircular pattern of vertebral involvement, contiguous vertebral body involvement, and absence of intervertebral disc edema and enhancement.

Original languageEnglish (US)
Pages (from-to)1567-1572
Number of pages6
JournalAmerican Journal of Neuroradiology
Volume37
Issue number8
DOIs
StatePublished - Aug 1 2016

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Hyperostosis
Osteitis
Synovitis
Acne Vulgaris
Intervertebral Disc
Discitis
Delayed Diagnosis
Osteomyelitis
Radiography
Edema
Spine
Differential Diagnosis
Neoplasm Metastasis
Biopsy
Bone and Bones

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

Cite this

McGauvran, A. M., Kotsenas, A. L., Diehn, F. E., Wald, J. T., Carr, C., & Morris, J. M. (2016). SAPHO Syndrome: Imaging findings of vertebral involvement. American Journal of Neuroradiology, 37(8), 1567-1572. https://doi.org/10.3174/ajnr.A4736

SAPHO Syndrome : Imaging findings of vertebral involvement. / McGauvran, A. M.; Kotsenas, A. L.; Diehn, F. E.; Wald, J. T.; Carr, Carrie; Morris, J. M.

In: American Journal of Neuroradiology, Vol. 37, No. 8, 01.08.2016, p. 1567-1572.

Research output: Contribution to journalArticle

McGauvran, AM, Kotsenas, AL, Diehn, FE, Wald, JT, Carr, C & Morris, JM 2016, 'SAPHO Syndrome: Imaging findings of vertebral involvement', American Journal of Neuroradiology, vol. 37, no. 8, pp. 1567-1572. https://doi.org/10.3174/ajnr.A4736
McGauvran AM, Kotsenas AL, Diehn FE, Wald JT, Carr C, Morris JM. SAPHO Syndrome: Imaging findings of vertebral involvement. American Journal of Neuroradiology. 2016 Aug 1;37(8):1567-1572. https://doi.org/10.3174/ajnr.A4736
McGauvran, A. M. ; Kotsenas, A. L. ; Diehn, F. E. ; Wald, J. T. ; Carr, Carrie ; Morris, J. M. / SAPHO Syndrome : Imaging findings of vertebral involvement. In: American Journal of Neuroradiology. 2016 ; Vol. 37, No. 8. pp. 1567-1572.
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