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Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings

Authors
  • Yu, Meiyan1
  • Cao, Yihan2
  • Li, Junqiu1
  • Zhang, Yanan1
  • Ye, Yuqian3
  • Wang, Lun3
  • Huang, Ziwei4
  • Lu, Xinyu3
  • Li, Chen5
  • Huo, Jianwei1
  • 1 Capital Medical University, Mei Shu Guan Hou Street, Beijing, 100010, China , Beijing (China)
  • 2 Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China , Beijing (China)
  • 3 Institute of Clinical Medicine, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China , Beijing (China)
  • 4 Beijing University of Traditional Chinese Medicine, Beijing, 100029, China , Beijing (China)
  • 5 Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, No.1, Shuai Fu Yuan, Beijing, 100730, China , Beijing (China)
Type
Published Article
Journal
Arthritis Research & Therapy
Publisher
Springer Science and Business Media LLC
Publication Date
Sep 14, 2020
Volume
22
Issue
1
Identifiers
DOI: 10.1186/s13075-020-02309-6
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe anterior chest wall (ACW) involvement is characteristic of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, yet little research has focused on its magnetic resonance imaging (MRI) findings.PurposeTo characterize the MRI features of the ACW in patients with SAPHO syndrome.MethodsSeventy-one patients with SAPHO syndrome and ACW involvement evidenced by bone scintigraphy were recruited in this cross-sectional study. The ACW region was scanned using sagittal, axial, and oblique coronal Dixon T2-weighted sequences and axial Dixon T1-weighted sequences. The characteristics of both active inflammatory and chronic structural lesions were evaluated.ResultsThe ACW lesions exhibited an asymmetrical distribution and a predilection for the sternocostoclavicular region (93.0%). Notably, 91.5% of the patients had lesions in the area of the anterior first ribs. Bone marrow edema (BME) was observed in 63 (88.7%) patients, which mainly affected the sternocostal joints (87.3%) and the manubrium sterni (84.5%). All of the BMEs were distributed under the articular surface or the bone cortex, consistent with the distribution of the ligaments and joint capsules. Synovitis was detected in 64 (90.1%) patients, with a predilection for the sternoclavicular joints (76.1%). A soft tissue mass or infiltration was found in all the patients who had bone marrow edema. Thirteen (18.3%) patients showed venous stenosis. Structural changes included bone bridge formation (80.3%), hyperostosis (43.7%), and fat infiltration (39.4%). Four common patterns of involvement were observed: the first rib area, the sternoclavicular area, the sternal angle area, and the areas of the second to sixth sternocostal joints.ConclusionThe ACW lesions of SAPHO syndrome demonstrated a triad of enthesitis, synovitis, and osteitis, suggesting complex interactions among the ligaments, synovium, and bones in the region. The inflammatory changes in the first rib area were highlighted in SAPHO syndrome.

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