SAPHO Syndrome Mimicking Metastases on Bone Scintigraphy

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Abstract
SAPHO syndrome is an acronym for a cluster of clinical manifestations including synovitis, acne, palmoplantar pustulosis, hyperostosis, and osteitis. The pathogenesis is unknown. It has a propensity for the anterior chest wall, characterized by sclerosis, hyperostosis, and arthritis of the sternoclavicular joints and costochondral junctions. It may also affect the spine and sacroiliac joints. Long bone involvement may mimic malignancy or infection radiologically. A case is presented with features suggestive of metastatic disease. The combination of sternoclavicular and appendicular involvement provided clues to the diagnosis on bone scintigraphy. Awareness of this unusual syndrome is necessary to avoid misdiagnosis.

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