99Tcm-MDP SPECT/CT observation on bone and joint involvement of SAPHO syndrome
Objective To observe bone and joint involvement of synovitis-acne-pustulosis-hypertrophy-osteitis(SAPHO)syndrome on 99Tcm-MDP SPECT/CT imaging.Methods Data of 69 cases with SAPHO syndrome were retrospectively analyzed.The mode of bone and joint involvement of SAPHO syndrome showed on 99Tcm-MDP SPECT/CT images observed and classified using Cluster analysis.Results Whole body bone and joint lesions could be classified as rib type(n=19),spine type(n=32)and stemoclavicular joint type(n=18)using cluster analysis.Totally 145 lesions were detected in 19 rib type cases,including 60 rib involvements(distributed in all 19 cases)and 95 other lesions.More than half rib lesions showed low to moderate uptake,half showed osteolytic bone destruction,while a few without obvious density changes.In 32 cases of spinal type,the axial bones were involved in 84.38％(27/32),and most spinal lesions involved one side of the costovertebral joint and showed continuous distributions,as well as low to moderate uptake.The sternoclavicular joint was involved in all 18 cases of sternoclavicular joint type,typically characterized by"bull head sign"or"half bull head sign",and more than half lesions located in sternoclavicular joint and showed moderate to high uptake,with hyperosteogeny and hypertrophy of bone cortex.Conclusion SAPHO syndrome involved bone and joint might be classified as rib type,spinal type and sternoclavicular joint type.When whole body imaging failed to detect typical characteristics like"bull head sign"or"half bull head sign",combining with clinical data and SPECT/CT findings were helpful for diagnosing SAPHO syndrome.
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