Hyperostosis and multifocal osteitis: a purely rheumatological subset of the SAPHO syndrome.

SAPHO has recently been proposed as an acronym to identify a syndrome characterized by synovitis, acne, pustulosis, hyperostosis and osteomyelitis. Several authors have, however, found that this rare condition may even occur without cutaneous manifestations. The work reported here presents the case of a 43-year-old male with skeletal involvement alone. An in-depth study of the patient revealed the arthro-osteitic pattern typical of the SAPHO syndrome. In agreement with previous reports, these data confirm that the present clinical picture of hyperostosis and osteitis, even without cutaneous involvement, is nonetheless related to the SAPHO syndrome.

[The elbow exposed to vibrating instruments and idiopathic diffuse skeletal hyperostosis: association or pure coincidence?]. / Gomito da strumenti vibranti ed iperostosi scheletrica idiopatica diffusa: un'associazione puramente casuale?

A group of 11 patients with chronic enthesopathy of the elbow caused by vibrating instruments was systematically examined for spinal signs of diffuse idiopathic skeletal hyperostosis (DISH). Nine patients revealed spinal involvement, the two exceptions probably relating to the patients' youth. The findings support the hypothesis that DISH is not a disease but rather a tendency to excessive ossification of ligamentous structures in response to stimuli that generally produce only modest new bone formation. Those suffering from such ossifying diathesis should be directed towards work unlikely to damage the enthesis.