Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings
Abstract Background The 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. Purpose To characterize the MRI features of the ACW in patien...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | Arthritis Research & Therapy |
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| Online Access: | http://link.springer.com/article/10.1186/s13075-020-02309-6 |
| _version_ | 1818575642274299904 |
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| author | Meiyan Yu Yihan Cao Junqiu Li Yanan Zhang Yuqian Ye Lun Wang Ziwei Huang Xinyu Lu Chen Li Jianwei Huo |
| author_facet | Meiyan Yu Yihan Cao Junqiu Li Yanan Zhang Yuqian Ye Lun Wang Ziwei Huang Xinyu Lu Chen Li Jianwei Huo |
| author_sort | Meiyan Yu |
| collection | DOAJ |
| description | Abstract Background The 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. Purpose To characterize the MRI features of the ACW in patients with SAPHO syndrome. Methods Seventy-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. Results The 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. Conclusion The 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. |
| first_indexed | 2024-12-15T00:43:40Z |
| format | Article |
| id | doaj.art-ab336109711e40c58990b9090cd21c3d |
| institution | Directory Open Access Journal |
| issn | 1478-6362 |
| language | English |
| last_indexed | 2024-12-15T00:43:40Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
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| series | Arthritis Research & Therapy |
| spelling | doaj.art-ab336109711e40c58990b9090cd21c3d2022-12-21T22:41:35ZengBMCArthritis Research & Therapy1478-63622020-09-0122111010.1186/s13075-020-02309-6Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findingsMeiyan Yu0Yihan Cao1Junqiu Li2Yanan Zhang3Yuqian Ye4Lun Wang5Ziwei Huang6Xinyu Lu7Chen Li8Jianwei Huo9Department of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityDepartment of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesDepartment of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityDepartment of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityInstitute of Clinical Medicine, Peking Union Medical College and Chinese Academy of Medical SciencesInstitute of Clinical Medicine, Peking Union Medical College and Chinese Academy of Medical SciencesSchool of Traditional Chinese Medicine, Beijing University of Traditional Chinese MedicineInstitute of Clinical Medicine, Peking Union Medical College and Chinese Academy of Medical SciencesDepartment of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical SciencesDepartment of Radiology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityAbstract Background The 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. Purpose To characterize the MRI features of the ACW in patients with SAPHO syndrome. Methods Seventy-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. Results The 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. Conclusion The 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.http://link.springer.com/article/10.1186/s13075-020-02309-6SAPHO syndromeMagnetic resonance imagingAnterior chest wallBone marrow edemaEnthesitisSynovitis |
| spellingShingle | Meiyan Yu Yihan Cao Junqiu Li Yanan Zhang Yuqian Ye Lun Wang Ziwei Huang Xinyu Lu Chen Li Jianwei Huo Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings Arthritis Research & Therapy SAPHO syndrome Magnetic resonance imaging Anterior chest wall Bone marrow edema Enthesitis Synovitis |
| title | Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings |
| title_full | Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings |
| title_fullStr | Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings |
| title_full_unstemmed | Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings |
| title_short | Anterior chest wall in SAPHO syndrome: magnetic resonance imaging findings |
| title_sort | anterior chest wall in sapho syndrome magnetic resonance imaging findings |
| topic | SAPHO syndrome Magnetic resonance imaging Anterior chest wall Bone marrow edema Enthesitis Synovitis |
| url | http://link.springer.com/article/10.1186/s13075-020-02309-6 |
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