SAPHO综合征的影像表现

目的 探讨SAPHO综合征的影像学表现。方法 回顾性分析20例SAPHO综合征患者的影像学表现。结果 19例病变累及前上胸壁,X线、CT表现为骨及肋软骨硬化、肥厚,关节破坏、强直,胸骨柄、锁骨近端和第1肋软骨受累,其中双侧不对称受累8例,双侧对称性受累7例,单侧受累4例。10例柄胸联合受累,6例第2肋软骨受累。5例伴有脊柱病变,X线、CT表现为多发椎体终板侵蚀、硬化,椎旁骨化,椎间隙变窄,椎体楔形变;MRI表现为椎体不均匀长T1长T2信号。3例伴骶髂关节受累,X线和CT表现为关节破坏、强直。结论 前上胸壁病变是SAPHO综合征最具特征性的影像学表现。

Imaging features of SAPHO syndrome

Objective To explore the imaging features of patients with synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Methods Imaging features of 20 patients with SAPHO syndrome were retrospectively analyzed. Results Nineteen patients had anterior chest wall involvement, which showed bone sclerosis, hyperostosis, costal cartilage sclerotic hyperostosis, joint destruction and ankylosis on plain X-ray films and CT images. The medial end of clavicle, manubrium and the first costal cartilage were affected in 19 cases. Among them, bilaterally asymmetrical involvements were found in 8 cases, bilaterally symmetrical in 7 cases and unilateral in 4 cases, respectively. Manubriosternal junctions and the second costal cartilages were affected in 10 and 6 cases, respectively. Five patients had spinal involvement which showed endplate erosion, sclerosis, paravertebral ossification, narrowed disc space, wedged body on plain film and CT, inhomogeneous long T1 and long T2 signal intensities on MRI. Three patients also had sacroiliac joint involvement which showed joint destruction and ankylosis on plain film and CT. Conclusion Anterior chest wall lesions are the typical imaging features of SAPHO syndrome.