Bone sarcoidosis

Abstract

Sarcoidosis is a disease that exhibits extremely heterogeneous clinical manifestations. Although the lungs are the most commonly involved organs, the extension of the granulomatous process may also affect the bones. Almost any bone can be involved; curiously, the small bones of the hands and feet are most frequently affected. Diagnosis and recognition of osseous sarcoidosis is easy, but the therapy is disappointing. Corticosteroids and antimalarials may control pain and swelling, but usually do not influence the course of osseous sarcoidosis.

18F-FDG PET/CT detects systemic involvement in sarcoidosis

“…Cases presenting with heart, central nervous system and eye involvement or pulmonary hypertension are associated with poorer prognosis and systemically treated [2]. Bone involvement is relatively rare (1-14%) [3,4] and often asymptomatic.…”

Multiple Bone Fractures Found in a Young Sarcoidosis Patient with Long Stable Disease

“…Serum 1,25 (OH)2 vitamin D, ionized calcium, and alkaline phosphatase (ALP) were normal on admission (Table 1), although they seemed to be decreased because of the use of immunosuppressants and drugs that suppress bone resorption ( Table 2). Based on these findings, 1,25 (OH)2 vitamin D did not seem to play a major role in bone resorption in patients with osseous sarcoidosis (2). Ionized calcium and ALP levels might reflect bone resorption to some extent; however, they did not seem to be good markers of bone destruction because they were not elevated in this case.…”

“…The osseous lesions in this case presented with lytic lesions of the phalanges on hand X-ray. Previous reports of osseous sarcoidosis (2,4) stated that the lesions were bilateral and developed after a long duration of the disease. Differential diagnosis of lytic lesions of the phalanges includes osteomyelitis, neoplasms, gout, and hyperthyroidism (3).…”

“…The frequency of osseous involvement of sarcoidosis is varied depending on race, ranging from 1 to 13% (1). Almost any bone can be involved, and the short tubular bones of the hands and feet are most frequently affected (2). Radiographical features include well-defined lytic defects and a lacework, reticulated pattern (3).…”

“…Osseous involvement occurs primarily in patients with chronic sarcoidosis with involvement of multiple organs (4). Although bone lesions are often asymptomatic, the affected part may be tender and painful (2). The frequency of bone fractures caused by osseous sarcoidosis is rare (2), and only 12 cases have been reported to the best of our knowledge 2,[5][6][7][8][9][10][11][12][13][14].…”