The importance of bone scintigraphy in the diagnosis of sapho syndrome

The acronym SAPHO corresponds to a group of benign conditions that combine osteoarticular and skin involvement, with the diagnosis mainly being clinical and supported by imaging findings. Bone scintigraphy has a relevant role in this syndrome due to its sensitivity and early detection ability. We present 8 patients with SAPHO syndrome who presented with skin manifestations. All had palmoplantar pustulosis, either of recent onset or outbreak evolution. Some had associated osteoarticular pain in the shoulders, sternum, lumbar area or limbs. Bone scintigraphy with Tc-99m-diphosphonate showed pathological findings in all the patients, detecting sternoclavicular joint damage, which was the most frequent involvement in 7 patients, as well as in other less usual localizations.