Abstract
The syndromes synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) and
chronic recurrent multifocal osteomyelitis (CRMO) constitute a group of chronic relapsing
inflammatory osteoarticular disorders with frequently associated skin eruptions such
as palmoplantar pustulosis and acne conglobata and rather characteristic imaging features
in the form of osteitis and/or hyperostosis. CRMO predominantly occurs in children/adolescents
and SAPHO in adults. Any skeletal site can be involved, and the imaging appearances
vary, depending on the patient's age and the stage/age of the lesion. The diagnosis
may be difficult if there is no skin disease, but attention to characteristic imaging
appearances may help avoid misdiagnosis (e.g., infection and tumor) and thereby unnecessary
invasive procedures as well as facilitating early diagnosis and appropriate treatment.
This article provides an overview of the radiologic appearances of SAPHO/CRMO and
relevant pathogenetic, clinical, and pathologic features to facilitate the diagnosis
that often requires an interdisciplinary approach including radiologists.
Keywords
SAPHO - CRMO - osteitis - hyperostosis - spondyloarthritis
