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This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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A 54-years-old woman suffered from a bilateral pelvic and lumbar pain. She had a systemic investigation shows a diffuse bone lesions. A biopsy of iliac bone was done and revealed sarcoidosis. Bony manifestations of sarcoidosis are rare and challenging to diagnose. Our report shows that MRI with diffusion weighted sequences is a simple and non invasive technique to evaluate bone infiltration. It helps to distinguish inflammatory disease from metastatic lesions and to guide the osseous biopsy. Moreover, fluorodeoxyglucose PET scan, are useful in establishing the extent of damage and measuring disease activity.

Highlights Think about the epiploic appendagitis more frequently when dealing with an obese patient with predispositions. Understand the importance of imagery that avoids unnecessary surgery in case of uncomplicated epiploic appendagitis and make it possible to do a radiological drainage. Always make the necessary differential diagnoses before evoking appendagitis.

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