Psoriasis et Spondylarthropathie : Penser au Syndrome de SAPHO : À propos d’un cas

The SAPHO syndrome is a rare entity that combines inflammatory musculoskeletal involvement with dermatological lesions such as psoriasis. This case highlights the importance of this often under-recognized diagnosis in clinical practice. In a 55-year-old female patient, followed for 10 years for psoriasis, persistent low back pain and chest pain suggested axial psoriatic arthritis. The persistence of symptoms despite treatment with anti-IL-17 led to a bone scintigraphy, which revealed characteristic hyperfixations in the sternoclavicular joints and the manubriosternal junction, forming the "bull's head sign," pathognomonic of SAPHO syndrome. Management with methotrexate and adalimumab resulted in symptom improvement. This case underscores the need to consider SAPHO syndrome in the presence of an association of joint pain and dermatological lesions, as well as the crucial role of bone scintigraphy in establishing the diagnosis and guiding treatment