ICAR: endoscopic skull‐base surgery

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SAPHO syndrome associated spondylitis

The concept of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome has been well clarified, after Chamot et al. suggested this peculiar disorder in 1987. The most commonly affected site in SAPHO syndrome is the anterior chest, followed by the spine. However, the clinical course and taxonomic concept of SAPHO spinal lesions are poorly understood. This study was performed to analyze: (1) the detailed clinical course of spinal lesions in SAPHO syndrome, and (2) the relationship between SAPHO syndrome with spinal lesions and seronegative spondyloarthropathy. Thirteen patients with spondylitis in SAPHO syndrome were analyzed. The features of spinal lesions were a chronic onset with a slight inflammatory reaction, and slowly progressing non-marginal syndesmophytes at multi spinal levels, besides the coexistence of specific skin lesions. SAPHO syndrome, especially spinal lesions related to palmoplantar pustulosis, can be recognized as a subtype of seronegative spondyloarthropathy

Seronegative spondyloarthropathies: what radiologists should know

Inflammatory involvement of the spine and sacroiliac joints is the most peculiar feature of seronegative spondyloarthropathies (SpA), which include ankylosing spondylitis, psoriatic arthritis, reactive arthritis (Reiter's syndrome), enteropathic spondylitis (related to inflammatory bowel diseases) and undifferentiated spondyloarthropathies. SAPHO syndrome may also be considered a SpA, but there is no clear agreement in this respect. Imaging, along with clinical and laboratory evaluation, is an important tool to reach a correct diagnosis and to provide a precise grading of disease progression, influencing both clinical management and therapy. Conventional radiography, which is often the first-step imaging modality in SpA, does not allow an early diagnosis. Computed tomography (CT) demonstrates with a very high spatial resolution the tiny structural alterations of cortical and spongy bone before they become evident on plain film radiographs. Magnetic resonance imaging (MRI) is the only modality that provides demonstration of bone marrow oedema, which reflects vasodilatation and inflammatory hyperaemia. The primary aim of this review article was to examine the involvement of the spine and sacroiliac joints in SpA using a multimodal radiological approach (radiography, CT, MRI), providing a practical guide for the differential diagnosis of these conditions