Study On The Clinical Characteristics And Imaging Features In SAPHO Syndrome

ObjectivesThrough the analysis of the clinical data of 20 cases of SAPHO syndrome patients,including clinical manifestation,TCM syndrome and laboratory examination(the erythrocyte sedimentation rate,C-reactive protein and complement C3,complement C4,immunoglobulin G,immunoglobulin A,immunoglobulin M,rheumatoid factor,anti O and HLA-B27)and imaging(CT,whole body bone scintigraphy)and Pathological examination,thus to investigate the characteristics and regularity of SAPHO syndrome in patients with clinical symptoms,TCM syrndrome,laboratory examination,imaging examination and pathological examination,to provide new ideas for the diagnosis of SAPHO syndrome.Method:According to the SAPHO syndrome diagnostic criteria,SAPHO patients were collected in accordance with the diagnostic criteria.We collected the general information,imaging data and pathological data of patients.We studied the possible causes and symptoms of SAPHO syndrome,and further studied the related factors of SAPHO syndrome.Results:1.Clinical manifestation:Among 20 patients with SAPHO syndrome,9 cases were male and 11 cases were female.The age range was 18-60 years old,vsith an average age of 49±11 years.20 cases of patients with SAPHO syndrome have different degrees of skin damage and bone joint damage,which includes damage skin palmoplantar pustulosis,psoriasis,skin erythema;bone and joint damage including sternocostoclavicular hyperostosis,spine bone hyperplasia,peripheral joint disease and sacroiliitis.2.TCM syndrome:6 cases were dampness heat blockage,5 cases were blood stasis blocking,5 cases were liver and gallbladder qi stagnation,5cases were blood deficiency and wind dryness,1cases were liver and kidney deficiency.3.laboratory examination:In 20 patients,the positive rate of IgG was 15%,the positive rate of IgA was 20%,the positive rate of IgM was 20%,the positive rate of ESR was 40%,the positive rate of CRP was 35%,the positive rate of C3 was 20%,the positive rate of C4 was 20%,the positive rate of RFwas 10%,HLA-B27 and ASO was negative.4.Whole-body bone scintingrahy:Among whole-body bone scintingrahy,20 cases of patients with SAPHO syndrome were abnormal imaging agent in different degree of concentration,including 20 cases of S APHO syndrome patients with chest wall abnormal imaging agent uptake.12 cases of SAPHO patients with abnormal spine comprehensive imaging agent uptake.7 cases of SAPHO syndrome in patients with pelvic appearance abnormal imaging agent uptake.4 cases of SAPHO patients with abnormal synthesis of long bone imaging agent concentration.5.CT:In the 20 patients with SAPHO syndrome,the results of CT scan in 14patients were symmetrical and the results of CT scan in 6 patients were asymmetrical.The characteristics of CT scan for hyperosteogeny,destruction of bone and joint space stenosis,hypertrophic joint fusion;including 5 cases of SAPHO syndrome were CT scan showed bone sclerosis,6 cases of SAPHO’s syndrome in patients with the CT scan showed bone destruction,3 cases of SAPHO CT images patients with manifestations of joint space narrowing,6 cases of SAPHO’s syndrome in patients with CT imaging manifestations of fusion joint hypertrophy.According to the incidence of SAPHO syndrome of bone were classified,including 14 cases of SAPHO syndrome in patients with sternal lesions occurred,6 cases of SAPHO syndrome patients with clavicular lesions,14 cases of SAPHO syndrome patients with sternoclavicular joint and costal cartilage lesions,8 cases of SAPHO syndrome patients with rib lesions,4 cases of SAPHO syndrome patients thoracic lesions.6.Pathological examination:Biopsy of 10 cases of SAPHO syndrome in patients with palmoplantar skin lesions,biopsy of 7 cases of SAPHO syndrome in patients with plantar skin lesions,biopsy of 3 cases of SAPHO syndrome in patients with chest wall lesions.The histopathological examination revealed that pustule tissue was formed around the pathological tissue.There was a large number of inflammatory cells in and around the pustule tissue.Multiple keratinized tissues were seen in the surrounding tissues.Conclusion:SAPHO syndrome is a disease characterized by abnormal skin,bone and joint.Laboratory tests are low sensitivity and lack of specificity.SAPHO syndrome can be effectively diagnosed and staging through clinical and imaging examinations.Whole-body bone scintigraphy can detect bone damage in the whole body early,and CT can detect bone change and joint soft tissue lesion in time.Histopathology is not specific,but it is significant to differentiate between tumor and inflammatory disease.Therefore,the combination of clinical diagnosis and multiple imaging techniques can improve the cognition and understanding of SAPHO syndrome.