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  • Title: Successful treatment of primary chronic osteomyelitis in SAPHO syndrome with bisphosphonates.
    Author: Just A, Adams S, Brinkmeier T, Barsegian V, Lorenzen J, Schilling F, Frosch P.
    Journal: J Dtsch Dermatol Ges; 2008 Aug; 6(8):657-60. PubMed ID: 18266863.
    Abstract:
    The treatment of the painful osteomyelitis in patients with SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) is often a problem. A 53-year-old woman had experienced palmo-plantar pustular skin lesions for four years, and in the past two years complained about progressive breath-and movement-dependent pain of the sternum. On examination she had extensive palmoplantar pustules and a painful swelling in the area of the right sternoclavicular joint. The three-phase bone scintigraphy showed a strong focal enrichment in the right sternoclavicular joint and at the transition from the manubrium to the corpus sterni suggesting active osteo-chondritis. Initially prednisolone and ibuprofen were administered, but only the skin changes regressed. The strong sternal pain decreased only after infusion of 4 mg zoledronic acid over three days. In a follow-up examination after five months the patient was still free of pain. The bisphosphonates inhibit osteoclastic activity and lead to long-lasting improvement of osteo-articular complaints in the SAPHO syndrome.
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