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Clinical and radiologic evolution of synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: A single center study of a cohort of 71 subjects
Arthritis Care and Research , 06/03/09
Colina M et al. – Data suggest that a chronic course is the more common evolution of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. Female sex, elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) values, anterior chest wall (ACW) involvement, peripheral synovitis, and skin involvement at the onset seem to be associated with a chronic course.
Methods- An assessment of the basic features and outcomes of SAPHO syndrome
- Pts diagnosed between 1990 and 2008, who had a f/u of at least 2 yrs
- 71 pts (48 women); median disease duration at the end of f/u was 10 yrs, and the median f/u duration was 11 yrs
- 6 pts were diagnosed with Crohn's disease; 14 pts had never had cutaneous involvement, but 8 pts presented >1 skin manifestation
- 9 pts (13%) presented a limited (<6 mo) monophasic disease course, 25 (35%) had a relapsing-remitting course, and 37 (52%) had an acute painful phase with a prolonged course lasting >6 mo
- 4% pts were HLA-B27 positive; factors associated with a chronic disease course and involvement of new osteoarticular sites:
- female sex and the presence at onset of ACW involvement,
- peripheral synovitis, skin involvement, and
- high values of acute-phase reactants
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