Fig. 1

Active inflammatory lesions in the ACW shown by oblique coronal (a–c, e–n, p) and axial (d, o) water-only T2W Dixon images in patients with SAPHO syndrome. a Extended BME in the bilateral sternoclavicular region, resembling the “bull’s head” sign. b BME of the sternocostoclavicular region. c BME of the sternocostoclavicular region and the sternal angle. d BME of the ossified bones in the first left rib and the first right SCoJ. e Active inflammatory changes of the surrounding tissue of the first right rib and the first right SCoJ. f Active inflammatory changes of the right costoclavicular ligament area and the first right SCoJ. g BME of the medial end of the left clavicle. h BME of the medial ends of the bilateral clavicles. i BME and hyperostosis of the medial end of the right clavicle. j Active inflammatory changes of the left costoclavicular ligament area and the SClJ. k BME of the sternal angle. l Pseudowidening of the SClJ. m BME of the bilateral SClJs with pseudowidening of joint space and BME of the right side of the sternal angle. n Joint effusion in the bilateral second and third SCoJ. o Joint effusion in the bilateral first SCoJ and soft tissue mass behind the manubrium sterni. p Soft tissue infiltration in the chest wall. Lesions are indicated by red arrows. BME, bone marrow edema; SCoJ, sternocostal joint; SClJ, sternoclavicular joint