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SAPHO syndrome — SCE Rheumatology MCQ

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HardSpondyloarthropathiesSAPHO syndromeSCE Rheumatology

A 31-year-old man has acne conglobata, palmoplantar pustulosis and recurrent anterior chest wall pain. CT shows sternoclavicular hyperostosis and osteitis; cultures from a prior bone biopsy were negative. CRP is 36 mg/L. What is the most likely diagnosis?

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Correct answer: A — SAPHO syndrome

SAPHO syndrome combines synovitis, acne, pustulosis, hyperostosis and osteitis, often involving the anterior chest wall. Septic arthritis remains an important exclusion, but negative cultures and the skin-bone pattern support SAPHO. Recognition prevents repeated unnecessary antimicrobial courses.

Reference: BSR rheumatology curriculum