Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome
Also called
CHAOS: Chronic Hyperostosis, Arthritis, Osteomyelitis, Skin lesions
SKI-BO syndromes: Skin-bone syndromes
Subtypes:
CRMO: Chronic reccurent osteomyelitis
SCCH: Steno-Costo-Clavicular Hyperostosis
DSOM: Diffuse Sclerosing Osteomyelitis of Mandible
PAO/ PAPA: Pustular osteoarthritis
MAJEED: Genetic
CIBD: Chronic inflammatory bowel disease
NOMID/ CINCA: in infants/ neonates
Skin changes:
Seen before bone changes in 75%
After bone changes in 10%
Concurrent bone and skin changes in 15%
Bones:
In child, long bones are commonly involved
In adults, axial skeleton is commonly involed
Sternoclavicular joint:
Sternoclavicular hyperostosis
Bone scan - Bull's eye (Cross) sign
Vertebrae:
Erosion of vertebral body corner, simialar to AS
Discitis without soft tissue
Vertebral destruction
Vertebra plana
Vertebral sclerosis
Paravertebral ossification
Sacroiliac joint:
Sacroilitis - symmetrical
Long bones:
Upper limb involvement is very rare
References:
Laredo JD et al. SAPHO Syndrome: MR Appearance of Vertebral Involvement. Radiology 2007;242:825-831
