SAPHO

• Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis
• soft tissue calcification between medial clavicle, anterior upper ribs, manubrium
• HLA-B27 positive

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Clavicle Sclerosis

• SAPHO syndrome
• Osteomyelitis
• osteosarcoma
• Ewing sarcoma
• metastasis
• Paget disease
• aseptic necrosis of the clavicle

Pyknodysostosis

• congenitally dense bone
• short
• hypoplastic mandibles
• acroosteolysis with sclerosis: sharp and dense distal phalanges (pathognomonic)
• Toulouse-Lautrec syndrome

Osteopetrosis

• hereditary dense bone: congenital and tarda forms
• Congenital: at birth, lethal, anemia, jaundice, hepatosplenomegaly, infections
• Tarda: children and adult, mild, asymptomatic
• Bone-in-bone vertebre
• sandwich vertebrae; denser compared to rugger jersey spine in hyperparathyroidism

Diffuse Sclerosis of bone; Osteosclerosis

• Vascular: sickle cell
  
• Neoplasm: metastatic prostate, breast
• Drugs: vit D, fluroide
• Congenital: osteopetrosis, pyknodysostosis
• Endocrine/Metabolic: hyperparathyroidsm, renal osteodystrophy (MC)

Focal or Multifocal Sclerotic Disease

• Vascular
• Infection
• Neoplasm: 1) Primary – osteoma, osteosarcoma; 2) metastatic – prostate, breast
• Congenital: bone island, osteopoikilosis
• Trauma
• Endocrine/Metabolic: Paget’s disease