Objective To investigate the practices of doctors in the diagnosis and treatment of adult SAPHO syndrome. Methods A cross-sectional study was conducted by distributing online questionnaires to physicians across five hospitals, specifically targeting departments involved in the diagnosis and treatment of adult SAPHO syndrome, including rheumatology, dermatology, and orthopedics. Results A total of 103 clinical physicians participated in the survey.The three most commonly observed clinical features of adult SAPHO syndrome were elevated ESR and CRP (82/84), focal swelling and fever (73/84), and new lesions found on imaging (70/84). The primary diagnostic tools utilized were Whole body bone imaging (76.2%) and CT scans (60.1%), with less frequent use of MRI (22.6%) and positron emission tomography-computed tomography (PET-CT) (9.6%). Notably, only 14% of physicians reported never performing disease activity monitoring. Nearly all respondents (98%) selected nonsteroidal anti-inflammatory drugs (NSAIDs) as the first-line treatment. Additionally, 81% of physicians opted for target synthetic disease-modifying antirheumatic drugs (tsDMARDs), 78.6% for steroids, 71.4% for biological disease-modifying antirheumatic drugs (bDMARDs), 66.7% for conventional synthetic disease-modifying antirheumatic drugs (csDMARDs, and only 18.5% chose bisphosphonates (pamidronate and zoledronate). Conclusion While Whole body bone imaging and CT scans are widely used for the early diagnosis of adult SAPHO syndrome, there is a gap in the utilization of MRI and the practice of disease activity monitoring. Physicians prefer commonly used rheumatic drugs, but there remains limited application of bisphosphonates. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Highlight • Our study first systematically investigated Chinese physicians' perspectives on the diagnosis and treatment of adult SAPHO syndrome. • We pointed out that the utilization of imaging tools (such as MRI) and bisphosphonates was low, suggesting that the diagnostic strategy needs to be optimized. • This study may aid the research of SAPHO syndrome at home and abroad, providing references. </entry> </row> </tbody> </tgroup> </Table>

Physicians' perspectives on the diagnosis and treatment of adult SAPHO syndrome: a cross-sectional study from China

期刊论文
发表日期：

2025年11月17日

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Huaijuan Huang,
Fanzhang Meng,
Di Jin,
Zi Ye,
Zhimin Lin,
Xiujuan Hou,
Kai Yuan,
Chen Li

摘要

Objective

To investigate the practices of doctors in the diagnosis and treatment of adult SAPHO syndrome.

Methods

A cross-sectional study was conducted by distributing online questionnaires to physicians across five hospitals, specifically targeting departments involved in the diagnosis and treatment of adult SAPHO syndrome, including rheumatology, dermatology, and orthopedics.

Results

A total of 103 clinical physicians participated in the survey.The three most commonly observed clinical features of adult SAPHO syndrome were elevated ESR and CRP (82/84), focal swelling and fever (73/84), and new lesions found on imaging (70/84). The primary diagnostic tools utilized were Whole body bone imaging (76.2%) and CT scans (60.1%), with less frequent use of MRI (22.6%) and positron emission tomography-computed tomography (PET-CT) (9.6%). Notably, only 14% of physicians reported never performing disease activity monitoring. Nearly all respondents (98%) selected nonsteroidal anti-inflammatory drugs (NSAIDs) as the first-line treatment. Additionally, 81% of physicians opted for target synthetic disease-modifying antirheumatic drugs (tsDMARDs), 78.6% for steroids, 71.4% for biological disease-modifying antirheumatic drugs (bDMARDs), 66.7% for conventional synthetic disease-modifying antirheumatic drugs (csDMARDs, and only 18.5% chose bisphosphonates (pamidronate and zoledronate).

Conclusion

While Whole body bone imaging and CT scans are widely used for the early diagnosis of adult SAPHO syndrome, there is a gap in the utilization of MRI and the practice of disease activity monitoring. Physicians prefer commonly used rheumatic drugs, but there remains limited application of bisphosphonates.

Highlight

• Our study first systematically investigated Chinese physicians' perspectives on the diagnosis and treatment of adult SAPHO syndrome.

• We pointed out that the utilization of imaging tools (such as MRI) and bisphosphonates was low, suggesting that the diagnostic strategy needs to be optimized.

• This study may aid the research of SAPHO syndrome at home and abroad, providing references.