Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
Some researchers feel that the SAPHO syndrome is related to the
group of arthritis conditions which typically affect the spine,
called the spondyloarthropathies.
Treatment of SAPHO syndrome typically involves medications which reduce inflammation.
What is SAPHO syndrome?
SAPHO syndrome is a chronic disorder that involves the skin, bone, and joints. SAPHO is an
acronym for the combination of synovitis,
acne, pustulosis, hyperostosis, and osteitis.
Synovitis means inflammation of the joint lining (synovium).
Typically, this is manifests as warmth, tenderness, pain, swelling,
and stiffness of involved joints (arthritis).
Acne is a skin condition featuring tiny areas of inflammation
with pus formation at the hair follicles. Acne occurs most commonly
on the face and upper back.
Pustulosis is a very inflammatory skin condition resulting in
large fluid-filled blister-like areas (pustules), typically on
the palms of the hands and/or the soles of the feet. The skin
of these areas peels and flakes (exfoliates).
Hyperostosis means abnormal excessive growth of bone. The
hyperostosis
of the SAPHO syndrome frequently is located at the points of the
bone where tendons attach, generally in the chest wall.
Osteitis means inflammation of the bone. Patients with SAPHO
syndrome can develop inflammation of the sacroiliac joints
(sacroiliitis) as well as inflammation of the spine (spondylitis)
which leads to stiffness and pain of the neck and back.
Acne is a localized skin inflammation as a result of overactivity of oil glands at the
base of hair follicles. This inflammation, depending on its location, can take the form
of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with antiinflammatory medications.
Arthroscopy is a surgical procedure by which the internal
structure of a joint is examined for diagnosis and/or treatment using a
tube-like viewing instrument called an arthroscope. Arthroscopy was popularized in the 1960s
and is now commonplace throughout the world. Typically, it is performed by
orthopedic surgeons in an outpatient setting. When performed in the outpatient setting, patients can usually return
home after the procedure.
The technique of arthroscopy involves inserting the arthroscope, a small
tube that contains optical fibers and lenses, through tiny incisions in
the skin into the joint to be examined. The arthroscope is connected to a
video camera and the interior of the joint is seen on a television
monitor. The size of the arthroscope varies with the size of the joint
being examined. For example, the knee is examined with an arthroscope that
is approximately 5 millimeters in diameter. There are arthr...
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