scholarly journals Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome of femoral neoplasm-like onset: a case-based review

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110653
Author(s):  
Cheng Qiu ◽  
Lin Cheng ◽  
Haodong Hou ◽  
Tianyi Liu ◽  
Bohan Xu ◽  
...  
Keyword(s):  
Symptom Relief ◽  
Sapho Syndrome ◽  
Bone Lesions ◽  
Invasive Procedures ◽  
Timely Manner ◽  
Autoimmune Reaction ◽  
Skin Manifestations ◽  
Appropriate Treatment ◽  
Initial Onset ◽  
Musculoskeletal Manifestations

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an umbrella term covering a constellation of bone lesions and skin manifestations, but has rarely been clarified in the clinic. We report a 28-year-old woman who had initial onset of SAPHO syndrome with involvement of the femur, and she experienced a tortuous diagnostic course. We also performed a literature review of SAPHO syndrome cases involving the femur and summarize several empirical conclusions by integrating previous findings with our case. Furthermore, we propose our perspective that ailment of the skin caused by infection of pathogens might be the first hit for triggering or perpetuating the activation of the immune system. As a result, musculoskeletal manifestations are probably the second hit by crosstalk of an autoimmune reaction. The skin manifestations preceding bone lesions can be well explained. Current interventions for SAPHO syndrome remain controversial, but drugs aiming at symptom relief could serve as the first preference for treatment. An accurate diagnosis and appropriate treatment can cure patients in a timely manner. Although the pathogenesis of SAPHO syndrome remains to be determined, physicians and surgeons still need to heighten awareness of this entity to avoid invasive procedures, such as frequent biopsies or nonessential ostectomy.

Musculoskeletal Manifestations of Sarcoidosis: A Review Article

2019 ◽  
Vol 15 (2) ◽  
pp. 83-89 ◽  
Author(s):  
Somayeh Shariatmaghani ◽  
Roshanak Salari ◽  
Maryam Sahebari ◽  
Payman Shalchian Tabrizi ◽  
Masoumeh Salari
Keyword(s):  
Treatment Options ◽  
Immunosuppressive Drugs ◽  
Bone Lesions ◽  
Symptomatic Management ◽  
Muscular Disease ◽  
Initial Symptoms ◽  
Skeletal Complications ◽  
Musculoskeletal Manifestations ◽  
Fdg Pet Ct ◽  
Musculoskeletal Involvement

Background: Sarcoidosis is a multisystem inflammatory disease with an etiology that is not clearly understood. Amongst the different organs that may be affected, the lungs are the most common. Musculoskeletal manifestations of the disease are uncommon. Objectives: They include arthropathy, bone lesions, or myopathy, all of which may occur as initial symptoms or develop during the course of the disease. Methods: : Articular involvement my present as arthralgia or arthritis. Skeletal complications usually develop in the chronic state of the disease. Muscular disease is rare and usually asymptomatic. Appropriate imaging modalities including X-ray, MRI, FDG-PET/CT assist in the diagnosis of rheumatic sarcoidosis. However, biopsy is necessary for definite diagnosis. Result and Conclusion: In most cases of musculoskeletal involvement, NSAIDs and corticosteroids are sufficient for symptomatic management. For more resistant cases immunosuppressive drugs (i.e., methotrexate) and TNF- inhibitors are used. Our aim is to review various types of musculoskeletal involvement in sarcoidosis and their existing treatment options.

Hip screening in newborns in the UK: what are the latest guidelines?

2021 ◽  
pp. 1-7
Author(s):  
Ayla C Newton ◽  
Marion Bohatschek ◽  
Andreas Rehm ◽  
Elizabeth Ashby
Keyword(s):  
Physical Examination ◽  
Congenital Abnormalities ◽  
Screening Programme ◽  
Developmental Dysplasia ◽  
Special Focus ◽  
Timely Manner ◽  
Appropriate Treatment ◽  
The Uk

The Newborn and Infant Physical Examination screening is a national screening programme which aims to identify infants with congenital abnormalities to minimise the risk of long-term complications. It involves a top to toe examination with special focus on the heart, eyes, testes and hips. The hip component of the Newborn and Infant Physical Examination screen aims to pick up infants with developmental dysplasia of the hips and refer them for appropriate treatment in a timely manner. Guidelines for the hip section of have recently changed. This article reviews these changes, the timings of the follow up and investigations, and the diagnosis and management of developmental dysplasia of the hips.

scholarly journals Reasons for new MIS. Let's be fair: iTIND, Urolift and Rezūm

2020 ◽  
Author(s):  
Rodrigo Suarez-Ibarrola ◽  
Arkadiusz Miernik ◽  
Christian Gratzke ◽  
Dominik S. Schoeb
Keyword(s):  
English Literature ◽  
Symptomatic Relief ◽  
Symptom Relief ◽  
Outlet Obstruction ◽  
Clinical Results ◽  
Cochrane Library ◽  
Invasive Procedures ◽  
Safe Alternative ◽  
Long Term Follow Up

Abstract Purpose To review and discuss the literature regarding iTIND, Urolift and Rezūm and investigate the precise clinical indications of all three different approaches for their application in benign prostatic hyperplasia (BPH) treatment. Materials and methods The PubMed–Medline and Cochrane Library databases were screened to identify recent English literature relevant to iTIND, Urolift and Rezūm therapies. The surgical technique and clinical results for each approach were summarized narratively. Results iTIND, Urolift and Rezūm are safe and effective minimally invasive procedures for the symptomatic relief of lower urinary tract symptoms (LUTS) due to BPH. iTIND requires the results of ongoing prospective studies, a long-term follow-up and a comparison against a reference technique to confirm the generalizability of the first pivotal study. Urolift provides symptomatic relief but the improvements are inferior to TURP at 24 months and long-term retreatments have not been evaluated. Rezūm requires randomized controlled trials against a reference technique to confirm the first promising clinical results. However, clinical evidence from prospective clinical trials demonstrates the efficacy and safety of these procedures in patients with small- and medium-sized prostates. Conclusions Although iTIND, Urolift, and Rezūm cannot be applied to all bladder outlet obstruction (BOO) cases resulting from BPH, they provide a safe alternative for carefully selected patients who desire symptom relief and preservation of erectile and ejaculatory function without the potential morbidity of more invasive procedures.

scholarly journals Role of Physical Therapy and Rehabilitation in SAPHO Syndrome- A Rare Condition

2021 ◽  
Author(s):  
Shail Sachdeva ◽  
Sonia Pawaria
Keyword(s):  
Physical Therapy ◽  
Rating Scale ◽  
Short Form ◽  
Age Groups ◽  
Rare Condition ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Sapho Syndrome ◽  
Unknown Etiology ◽  
Bone Lesions

SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) is heterogenous, rare entity with manifestations of Pustulo-Psoriatic Hyperostotic Spondyloarthritis (PPHS) and Chronic Recurrent Multifocal Osteomyelitis (CRMO). It can occur in all the age groups with unknown etiology. Hereby, author presents a case of 37-year-old female who reported with the complaint of bilateral knee pain and lower back pain. Laboratory investigations revealed elevated Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) levels. Bone scintigraphy and Magnetic Resonance Imaging (MRI) showed bone lesions, The diagnosis of SAPHO syndrome was made. The present article highlights the role of physical therapy as a non-pharmacological treatment modality to reduce pain, the intensity of which was measured by Numeric Pain Rating Scale (NPRS). The Range Of Motion (ROM) was measured by digital inclinometer and her Quality of Life (QoL) was measured by the 36-item short form health survey (SF-36) scale. Eight weeks postprotocol showed significant improvement in pain, ROM and QOL. This suggests a positive outcome of rehabilitation in SAPHO syndrome.

Chronic Recurrent Multifocal Osteomyelitis Involving the Mandible – A Rare Case Report

2021 ◽  
Vol 45 (4) ◽  
pp. 273-277
Author(s):  
Abrar Alamoudi ◽  
Niranzena Panneer Selvam ◽  
Deeba Kashtwari ◽  
Axel Ruprecht ◽  
Matthew Hansen
Keyword(s):  
Treatment Plan ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Primary Objective ◽  
Bone Lesions ◽  
Radiographic Appearance ◽  
Appropriate Treatment ◽  
Bone Biopsies ◽  
Rare Case Report ◽  
Multifocal Osteomyelitis ◽  
Autoinflammatory Condition

Chronic recurrent multifocal osteomyelitis (CRMO) is an uncommon, aseptic, autoinflammatory condition characterized by multifocal bone lesions with pain, swelling, and frequent exacerbations and remissions. It is noteworthy that these lesions occur without any identifiable etiology or microbiologic finding. The clavicle and metaphyses of the long bones are often involved whereas involvement of the mandible is considered rare. It is usually diagnosed by exclusion of other diseases. As it shares most of its features with the more commonly occurring infective osteomyelitis, patients are often unnecessarily subjected to prolonged courses of antibiotics, serial radiation exposures, and repeated bone biopsies. We present a case of CRMO involving the mandible. Our primary objective is to demonstrate the clinical features of this uncommon disorder, highlighting the radiographic appearance. Familiarity with this condition among radiologists greatly increases the likelihood for early diagnosis and formulating an appropriate treatment plan.

scholarly journals Endovascular repair of spontaneous popliteal artery pseudoaneurysm

2020 ◽  
Vol 13 (2) ◽  
pp. e231200
Author(s):  
Sergio Quilici Belczak ◽  
Leonardo Garcia Góes ◽  
Vanessa Stefaniak
Keyword(s):  
Popliteal Artery ◽  
Popliteal Fossa ◽  
Bone Lesions ◽  
Invasive Procedures ◽  
Artery Pseudoaneurysm ◽  
Previous Trauma ◽  
Local Trauma ◽  
History Of ◽  
Popliteal Artery Pseudoaneurysm ◽  
Rule Out

Popliteal artery pseudoaneurysms are rare and are generally associated with local trauma, such as orthopaedic surgery or expansile bone lesions in the popliteal fossa. The authors describe a case of popliteal artery pseudoaneurysm in a 24-year-old man. A thorough workup revealed no history of trauma, invasive procedures, vasculitis or any other factors that could constitute a probable cause of the pseudoaneurysm. However, as the patient practices running, it is not possible to rule out minor previous trauma that has not been noticed.

Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome presenting as a primary calvarial lesion

2000 ◽  
Vol 93 (4) ◽  
pp. 693-697 ◽  
Author(s):  
Francesco Dimeco ◽  
Richard E. Clatterbuck ◽  
Khan W. Li ◽  
Edward F. McCarthy ◽  
Alessandro Olivi
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Procedures ◽  
Clinical Entity ◽  
Sapho Syndrome ◽  
Bone Lesions ◽  
Content Type ◽  
First Report ◽  
Skull Vault ◽  
Fine Print

✓ The synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a recently described, currently evolving clinical entity that groups together several idiopathic disorders of bone and skin formerly described under a variety of names. Among the spectrum of possible locations for the bone lesions, there is no previous report in the literature of primary involvement of the skull vault. A patient with primary involvement of the calvaria in the setting of SAPHO syndrome is described here, which, to the authors' knowledge, is the first report of such localization. The clinically and radiologically benign evolution of the different stages of the bone lesions is presented. The authors suggest that the SAPHO syndrome should be considered in the differential diagnosis of lytic, sclerotic, or hyperostotic lesions of the skull, particularly before considering invasive diagnostic procedures.

scholarly journals Case Report: SAPHO Syndrome Mimicking Bone Metastases During Treatment With Pembrolizumab for Non-small Cell Lung Cancer

2021 ◽  
Vol 8 ◽  
Author(s):  
Yuko Kubo ◽  
Kimiteru Ito ◽  
Yutaka Fujiwara ◽  
Tatsuya Yoshida ◽  
Masahiko Kusumoto
Keyword(s):  
Bone Metastases ◽  
Stage Iv ◽  
Sapho Syndrome ◽  
Bone Lesions ◽  
Thoracic Vertebrae ◽  
Cell Lung Carcinoma ◽  
Abdominal Lymph Node ◽  
Prednisolone Treatment ◽  
Magnetic Resonance Imaging Mri

A 69-year-old female with recurrent stage IV squamous cell lung carcinoma and metastatic abdominal lymph node but not bone metastases was being treated with pembrolizumab. Four months after starting the recurrent treatment, the tumour reduced in size but she began to complain of back pain and palmar rash. A bone scan showed uptake lesions in the left sternocostal joints and vertebrae, while spine magnetic resonance imaging (MRI) showed multiple lesions in the thoracic vertebrae. Her heterogeneous lesions, such as skin and multiple bone manifestations, were comprehensively diagnosed as SAPHO syndrome by different experts. Furthermore, the SAPHO syndrome was suspected to be an immune-related adverse event induced by pembrolizumab, and pembrolizumab withdrawal and prednisolone treatment were performed. Subsequently, her symptoms improved and the follow-up imaging findings showed that the bone lesions had almost disappeared. This case demonstrates that SAPHO syndrome mimicking bone metastases developed during treatment with pembrolizumab. SAPHO syndrome is rare and bone lesions related to the disease may be misdiagnosed as bone metastases. Therefore, it is important in the future for various physicians to have a better understanding of SAPHO syndrome and to consider the potential relationship between this disease and immunotherapy.

scholarly journals Implementation and Validation of Telepathology Triage at Cancer Referral Center in Rural Rwanda

2016 ◽  
Vol 2 (2) ◽  
pp. 76-82 ◽  
Author(s):  
Tharcisse Mpunga ◽  
Bethany L. Hedt-Gauthier ◽  
Neo Tapela ◽  
Irenee Nshimiyimana ◽  
Gaspard Muvugabigwi ◽  
...  
Keyword(s):  
District Hospital ◽  
Correct Diagnosis ◽  
Turnaround Time ◽  
Timely Manner ◽  
Entire Sample ◽  
Histologic Diagnosis ◽  
Standard Glass ◽  
Resource Limited ◽  
Appropriate Treatment

Purpose Connecting a cancer patient to the appropriate treatment requires the correct diagnosis provided in a timely manner. In resource-limited settings, the anatomic pathology bridge to efficient, accurate, and timely cancer care is often challenging. In this study, we present the first phase of an anatomic telepathology triage system, which was implemented and validated at the Butaro District Hospital in northern rural Rwanda. Methods Select cases over a 9-month period in three segments were evaluated by static image telepathology and were independently evaluated by standard glass slide histology. Each case via telepathology was classified as malignant, benign, infectious/inflammatory, or nondiagnostic and was given an exact histologic diagnosis. Results For cases triaged as appropriate for telepathology, correlation with classification and exact diagnosis demonstrated greater than 95% agreement over the study. Cases in which there was disagreement were analyzed for cause, and the triage process was adjusted to avoid future problems. Conclusion Challenges to obtaining a correct and complete diagnosis with telepathology alone included the need for immunohistochemistry, assessment of the quality of images, and the lack of images representing an entire sample. The next phase of the system will assess the effect of telepathology triage on turnaround time and the value of on-site immunohistochemistry in reducing that metric and the need for evaluation outside of telepathology.

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