Clinical Images: Refractory SAPHO syndrome involving the mandible.

The article describes the case of a 55 year old woman with a history of psoriasis who experienced debilitating pain in the right jaw for 4 years which was associated with episodes of trismus related to flares of febrile inflammation in the same area. A bone scintigraphy was performed which confirmed synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) sydrome. Subcutaneous anti-tumor necrosis factor therapy was implemented that lead to complete regression of the symptoms.