Oral and maxillofacial surgerySAPHO (synovitis-acne-pustulosis-hyperostosis-osteitis): a multidisciplinary approach

ObjectiveThe aim of this study is to suggest a model for inquiry and treatment of patients with undiagnosed multiple inflammatory reactions.Study DesignA retrospective study was performed using 43 patient records from patients with chronic osteomyelitis of the jaw, treated at the Oral and Maxillofacial Clinic at Södersjukhuset, Stockholm, Sweden. The diagnoses primary chronic osteomyelitis (PCO) or secondary chronic osteomyelitis (SCO) were eventually made, according to symptoms and course of disease.ResultsA total of 85% of the PCO patients fulfilled the criteria of the disorder SAPHO (synovitis-acne-pustulosis-hyperostosis-osteitis). The difficulty of settling on the diagnosis, as well as the length and diversity of treatment, was extreme. After treatments became multidisciplinary, time between diagnosis and cure was halved.ConclusionsIn order to improve diagnostics and treatment of patients with chronic inflammatory disease of the jaw, a structured plan for examination and treatment is proposed.