TNF and spondylitis: The patient was treated with methotrexate, non-steroidal anti-inflammatory drugs and tumor necrosis factor inhibitors, with subsequent pain relief, normalization of inflammatory markers, and stable disease during follow-up.<h4>Conclusion</h4>Because of its non-specific and variable presentation, SAPHO syndrome is frequently misdiagnosed as malignancy, tuberculosis, spondylitis, psoriasis or other conditions.