The SAPHO syndrome in children: A rare cause of hyperostosis and osteitis

The SAPHO syndrome is a rare constellation of signs and symptoms characteri zed by synovitis, acne, pustulosis, hyperostosis, and osteitis. The most co mmon musculoskeletal complaints are hyperostosis, causing pain, tenderness, and swelling of the anterior chest wall, although any part of the axial an d appendicular skeleton may be affected. There is a great degree of variabi lity in the dermatologic involvement of this syndrome. A combination of cli nical, radiographic, and pathological investigation is required to establis h the correct diagnosis. No single treatment has been found to be effective , although nonsteroidal antiinflammatory drugs have been the most frequentl y used. Because there is no mention of SAPHO syndrome in the English orthop aedic literature, and pediatric orthopaedic surgeons may be the first careg ivers to treat these children, we thought it appropriate to share our exper ience with a 5-year-old boy with SAPHO syndrome recently under our care.