Asymmetric Osteitis and Pustulosis

A 36-year-old female patient, previously diagnosed with psoriatic arthritis and initially unresponsive to multiple treatments, experienced a subsequent asymptomatic period before developing new symptoms, including limited right-sided inflammatory lumbosacral pain and pustules on her palms and soles. Magnetic resonance imaging revealed changes consistent with osteitis. These findings prompted a reassessment of her condition, leading to a revised diagnosis of SAPHO syndrome.