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SAPHO syndrome with mandibular manifestation

A 47-year-old man was referred to our hospital due to symptoms of trismus and exacerbation of palmoplantar pustulosis. He had been presenting, for 20 years, with refractory and recurrent mandibular osteomyelitis accompanied by palmoplantar pustulosis and anterior chest pain—symptomatic treatment and surgery had been given at each presentation. When the mandibular lesion got worse this time, he also had anterior chest pain. He had experienced similar episodes before this event. MRI (STIR: short tau inversion recovery) showed high signal intensity in the right ramus of the mandible, with perilesional soft tissue swelling …