Author(s)

Yang Xin ¹, Jin Shasha ¹, Lu Huiting ¹, Zhao Chan ²

Affiliation(s)

¹ First Clinical School of Medicine, Shaanxi University of Chinese Medicine, Xianyang, China
² Department of Dermatology, Baoji Hospital of Traditional Chinese Medicine Affiliated with Shaanxi University of Chinese Medicine, Baoji, China

Corresponding Author

Zhao Chan

ABSTRACT

SAPHO syndrome is a rare chronic inflammatory disorder characterized by synovitis, acne, pustulosis, hyperostosis, and osteitis, which is often misdiagnosed due to its heterogeneous clinical manifestations. We report a 54-year-old male patient presenting with low back pain radiating to both lower limbs for 4 days and a 10-year history of palmoplantar pustulosis. Physical examination revealed scattered erythema, scaling, pustules, and crusts on both lower limbs and feet. Laboratory tests showed no specific abnormalities. Imaging examinations demonstrated sternoclavicular and sternocostal arthritis, lumbar disc bulging, spinal stenosis, and degenerative changes. Whole body bone scintigraphy revealed increased radiotracer uptake at the bilateral proximal clavicles, upper sternum, and L3 spinous process, consistent with the characteristic bull's head sign, confirming the diagnosis of SAPHO syndrome. The patient received integrated traditional Chinese and Western medicine therapy, including oral herbal decoction, external herbal application, fire acupuncture, nonsteroidal anti inflammatory drugs, and topical dermatological agents. After treatment, the patient's low back and lower limb pain was significantly relieved, and plantar lesions improved. This case highlights that whole body bone scintigraphy is crucial for early diagnosis in patients with sequentially occurring cutaneous and osteoarticular manifestations, which can effectively reduce misdiagnosis and improve clinical outcomes.

KEYWORDS

SAPHO syndrome, palmoplantar pustulosis, bull's head sign

CITE THIS PAPER

Yang Xin, Jin Shasha, Lu Huiting, Zhao Chan. A Case of SAPHO Syndrome. MEDS Clinical Medicine (2026). Vol. 7, No.2, 112-118. DOI: http://dx.doi.org/10.23977/medsc.2026.070214.

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