Chronic osteomyelitis of clavicle as primary manifestation of SAPHO syndrome in adolescents: report of four cases and long-term evolution

Four cases of chronic osteomyelitis of clavicle as primary manifestation of synovitis, acne, pustulosis, hyperostosis, osteomyelitis (SAPHO) are reported in adolescents. In all cases a typical radiographical evolution had been observed with progressive slow migration of sclerotic area from medial to lateral side of clavicle. Long-term evolution was alternation of remission and exacerbation but none of the patients healed.