TNF and SAPHO syndrome: An expert consensus in 2025 named SAPHO syndrome as chronic non-bacterial osteitis(CNO) in adults and proposed a phased treatment plan: first-line treatment uses non-steroidal anti-inflammatory drugs (NSAIDs) or cyclooxygenase-2 inhibitors (COXIBs); second-line treatment requires adding or switching to intravenous bisphosphonates (IVBP, generally preferred) or tumor necrosis factor-α inhibitors (TNFi); third-line treatment requires referral to a specialist center to obtain a third-line treatment plan (11).