Diffuse sclerosing osteomyelitis of the mandible: its characteristics and possible relationship to synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome

J Oral Maxillofac Surg. 1996 Oct;54(10):1194-9; discussion 1199-200. doi: 10.1016/s0278-2391(96)90349-3.


Purpose: This article reports on the possible relationship of diffuse sclerosing osteomyelitis (DSO) of the mandible to synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome.

Patients and methods: The pathologic features in 12 new DSO patients and those in previously reported cases were reviewed and compared with those of SAPHO syndrome.

Results: Many similarities were noted between the two entities in terms of the clinical, radiographic, and histologic features. Furthermore, multiple bone lesions and skin lesions (palmoplantar pustulosis and psoriasis) were observed not only in SAPHO syndrome but also in DSO patients.

Conclusion: DSO is concluded to be one manifestation of SAPHO syndrome.

Publication types

  • Comparative Study

MeSH terms

  • Acne Vulgaris / pathology
  • Adult
  • Aged
  • Female
  • Humans
  • Hyperostosis / pathology
  • Male
  • Mandibular Diseases / classification*
  • Mandibular Diseases / diagnostic imaging
  • Mandibular Diseases / pathology*
  • Mandibular Diseases / therapy
  • Middle Aged
  • Osteitis / pathology
  • Osteomyelitis / classification
  • Osteomyelitis / diagnostic imaging
  • Osteomyelitis / pathology*
  • Osteomyelitis / therapy
  • Psoriasis / pathology
  • Radiography
  • Syndrome
  • Synovitis / pathology