SAPHO—a diagnosis to consider in patients with refractory costochondritis

Abstract Background SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) is a rare, heterogeneous, self-limited disease of unknown etiology. It involves progressive bone joint damage, skin lesions may occur at different times in the course disease. Skin are characterized by neutrophil dermatosis. Its management empirical mainly symptomatic, nonsteroidal anti-inflammatory drugs first-line treatment. Case presentation Forty-seven-year-old female presented with 7-year history costochondral pain. had onset, chronical course, no other associated symptoms, involvement. She was treated intermittent NSAID (nonsteroidal drugs), which provided only partial pain relief; there bilateral tender swelling sternoclavicular region, over area slightly erythematous, but were lesions, based on imaging findings, diagnosis established. The patient received an infusion zoledronic acid subsequent complete resolution her chest wall completely improved after 3 days. Conclusions This case considered atypical syndrome, without changes, long-term persistence refractory established imaging, infusion. differential patients chronic costochondritis. Therapeutic failure to key its diagnostic suspicion. Also, early suspicion better outcomes.