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case_images: Lumbar spine imaging examination results revealed lumbar spine degeneration.
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case_images: L5-S1 vertebrae and intervertebral disc, narrowing of the intervertebral space, increased vertebral body density, and compressive changes in the L2 vertebrae (Figure 1A). Lumbar noncontrast MRI revealed L5-S1 vertebrae fixation. The L3/4 intervertebral disc slightly bulged, L2 vertebral body compression changes and abnormal signal, and T11-L2 vertebrae abnormal signal (Figure 1B).
case_images: Sacroiliac joint imaging examination results revealed osteitis of the left sacroiliac joint.
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case_images: Sacroiliac joint CT showed high intensity in the left sacroiliac joint (Figure 2A), which indicated osteitis of the left sacroiliac joint. Sacroiliac joint magnetic resonance imaging (MRI) revealed postoperative changes in the L5-S1 vertebrae (Figure 2B).
case_images: Dermatological manifestation.
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case_images: During re-examination, we found that her palms showed hyperkeratosis with active pustulosis (Figure 3A). Hyperkeratosis with active pustulosis on both palms fully resolved after 12 months of treatment (Figure 3B). The patient was followed up for 6 months after full recovery, and no recurrence was found in the symptoms of low back and lower extremity pain and palmar hyperkeratosis with active pustulosis (Figure 3C).
case_images: Skeletal ECT imaging.
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case_images: SAPHO syndrome and performed skeletal emission computed tomography (ECT). Skeletal ECT found a typical "horn sign" change on the sternum stem and revealed active bone metabolism of T8, T10, T11, L3, S1 vertebrae, bilateral sternoclavicular joints, bilateral sacroiliac joints, and bilateral knee joints, as well as increased bone density in some thoracic vertebrae (Figure 4).