SAPHO syndrome with pathological fractures of vertebral bodies: a case report

BMC Musculoskelet Disord. 2019 Jan 17;20(1):27. doi: 10.1186/s12891-019-2410-x.

Abstract

Background: It's difficult to diagnose and treat synovitis-acne-pustulosis-hyperostosis-osteomyelitis (SAPHO) syndrome due to its rare and unknown pathogenesis. There is no effective treatment for SAPHO syndrome and the consequences of empirical treatment are unpredictable. This study reports a case of a young female diagnosed as SAPHO syndrome with pathological fractures of vertebral bodies.

Case presentation: A 29-year-old female complained of the right sternoclavicular joint and back pain accompanied limited activities and cutaneous lesions. Laboratory assays revealed abnormal inflammatory factors. Multiple imaging studies illustrated bone lesions and pathological fractures of vertebral bodies. A diagnosis of SAPHO syndrome was made. The patient was treated with Compound Troxerutin and Poreine Cerebroside Injection, non-steroidal anti-inflammatory drugs (NSAIDs), bisphosphonates, corticosteroids and the thoracolumbar brace. The patient was followed up for 6 months and showed improved results.

Conclusions: The case supports that multiple image inspections and laboratory tests contribute to diagnose SAPHO syndrome, and combination therapies of Compound Troxerutin and Poreine Cerebroside Injection, NSAIDs, bisphosphonates, corticosteroids and the thoracolumbar brace in the treatment of SAPHO syndrome with pathological fractures of vertebral bodies are crucial to regain health.

Keywords: Bisphosphonates; Multiple bone lesions; Osteomyelitis; SAPHO syndrome; Steroids.

Publication types

  • Case Reports

MeSH terms

  • Acquired Hyperostosis Syndrome / complications*
  • Acquired Hyperostosis Syndrome / diagnosis
  • Acquired Hyperostosis Syndrome / drug therapy
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Braces
  • Female
  • Fractures, Spontaneous / diagnostic imaging
  • Fractures, Spontaneous / etiology*
  • Fractures, Spontaneous / surgery
  • Humans
  • Hydroxyethylrutoside / analogs & derivatives
  • Hydroxyethylrutoside / therapeutic use
  • Spinal Fractures / diagnostic imaging
  • Spinal Fractures / etiology*
  • Spinal Fractures / surgery
  • Spine / diagnostic imaging

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Hydroxyethylrutoside
  • troxerutin