Bone Scan and SPECT/CT Scan in SAPHO Syndrome.

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare clinical entity involving musculoskeletal and dermatologic systems. Its main features are prominent inflammatory cutaneous and articular manifestations. Anterior chest wall pain, more commonly at sternoclavicular and sternocostal joints, along with palmoplantar pustulosis and acne can point to this uncommon syndrome. Here, we report a case of a 15-year-old female, who presented with swelling at the anterior chest wall, was referred for the bone scan. Bone scintigraphy and single-photon emission computed tomography (SPECT/CT) detected classical "bull-head" sign, and further physical examination, for skin lesions, confirmed the diagnosis.