A Case of SAPHO Syndrome Presenting as Isolated Iliitis and Spondylitis
Why this work is in the frame
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Bibliographic record
Abstract
To the Editor: Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome has a variable presentation and it is now believed that a number of previously described entities are cases of SAPHO. These include chronic recurrent multifocal osteomyelitis (CRMO) and pustulotic arthro-osteitis1. We describe a case of SAPHO presenting with iliitis and pyoderma gangrenosum as the sole manifestations. A 39-year-old man was reviewed in the rheumatology outpatients department. He gave a history of episodic pain in both hips and his lower back since the age of 18 years. He had previously been diagnosed with HLA-B27-negative spondyloarthropathy at another center and had had a left hip replacement at the age of 22 years for secondary left hip osteoarthritis, and subsequently a revision of this at the age of 36 years when he fractured his left femur in a fall. He had developed a pyoderma gangrenosum at age 38 years. His clinical history and laboratory, radiological, and pathological investigations were reviewed. He had had persistently elevated inflammatory markers over the years, his latest erythrocyte sedimentation rate was 76 mm/h, C-reactive protein 73 mg/l, hemoglobin 10.2 g/dl, and platelets 596 × 109 … Address correspondence to Dr. Conway; E-mail: drrichardconway{at}gmail.com
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it