Anterior Chest Wall Involvement in a Child with Familial Mediterranean Fever: A Rare Manifestation and Diagnostic Challenge.

Anterior chest wall involvement is frequently seen in adult patients with spondyloarthropathy and often related to advanced axial disease and rarely reported in pediatric patients. In addition, anterior chest wall involvement is frequently encountered in patients with synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Despite treatments of these conditions were similar, differentiation of these two diseases might be challenging due to the overlapping features. Also, several rheumatic diseases, including spondyloarthropathy, could be seen in association with familial Mediterranean fever (FMF). Additionally, treatment of cases with concomitant FMF and spondyloarthropathy might be challenging due to the different biological drug needs of the diseases. Herein, we presented a case of sternoclavicular arthritis in a pediatric FMF patient for the first time and emphasize on the challenges in differentiating SAPHO from spondyloarthropathy and difficulties in treatment. [ABSTRACT FROM AUTHOR]