SAPHO syndrome treated with pamidronate

A middle aged man presented with a 4 year history of painful swelling of both knees and pustular acne on his back. The MRI scan of the knees showed gross synovitis, so did the histopathology of the synovium. A diagnosis of SAPHO syndrome was made and he was treated with IV pamidronate. His pain reduced and acne completely cleared up on therapy. A dermatologist has rarely made a diagnosis of SAPHO syndrome and treated it.