SAPHO syndrome preceded by chronic recurrent back pain for seven years before the appearance of a skin lesion: a case report

Abstract

Although back pain complaints are common among patients of pain clinics, there are also patients with a rare underlying disease. We present the case of a patient with synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome who was admitted to our hospital because of upper back pain. SAPHO syndrome consists of various osteoarticular and dermatological manifestations that can concurrently appear in a single patient. In this case, the patient complained of chronic recurrent back pain for seven years prior to the appearance of a skin lesion. MR imaging at the first visit revealed abnormal signal intensities in the sixth and seventh thoracic vertebral bodies. However, it was difficult to make a diagnosis without recognition of this syndrome. It should be considered that vertebral pain can occur before skin lesion development in patients with SAPHO syndrome.