• There is marked sclerosis and hypertrophy of the right sternocostal joint at the medial aspect of the right first, second and third rib. Similar changes are also seen at the manubriosternal joint and sternal body articulation with the xiphoid process. No significant changes are seen at the manubrio-clavicular joints.
• In addition, there is also prominent osteosclerosis with cancellous bone formation at T5-T8, with coarse anterior syndesmophytes at T7-T8 and anterior fusion at T5-T6 and T6-T7. I note the ALL is thickened at several levels. Moreover, there is marked cortical irregularity, hyperostosis and sclerosis at the left costotransverse joint of all the aforementioned levels. No destructive lytic bony lesion seen.
• Conclusion:The described changes at the right costo sternal joints and mid thoracic vertebral bodies are all consistent with SAPHO. Are there any clinical features to support this? There is no evidence of an underlying bone sarcoma.