A 28-year-old man presents with chronic anterior chest wall pain, swelling over the sternoclavicular joint, and acne vulgaris. X-ray shows hyperostosis and sclerosis of the sternoclavicular region. Which diagnosis best explains this presentation?
- A SAPHO syndrome ✓
- B Chronic pyogenic osteomyelitis
- C Tuberculous arthritis
- D Tietze syndrome
Correct answer: A. SAPHO syndrome
Explanation
SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) classically presents with sternoclavicular hyperostosis, osteitis, and associated skin manifestations like acne. The combination of anterior chest wall involvement with acne in a young adult is characteristic. Chronic pyogenic osteomyelitis would present with sinus formation and systemic signs. Tietze syndrome is costochondral, not sternoclavicular, and lacks hyperostosis.
Reference: Ruddy S, Kelley's Textbook of Rheumatology, 10th ed.
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