Musculoskeletal Manifestations of Sarcoidosis: A Review Article

Shariatmaghani, Somayeh Sadat; Salari, Roshanak; Sahebari, Maryam; Tabrizi, Payman Shalchian; Salari, Masoumeh

doi:10.2174/1573397114666180425111901

Cited by 14 publications

(19 citation statements)

References 54 publications

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“…Due to lack of specific description of periarthritis in the clinical notes, we are unable to report the frequency of periarthritis in this cohort. Prior studies have shown a female predominance for Lofgren syndrome, a higher prevalence of Lofgren syndrome in Caucasians while showing a low prevalence in Japan and India 3,7,14,15,17‐20 . We found Lofgren syndrome predominantly affecting the ankle joint (96.3%), which is similar to previous studies (reported between 75%‐90%).…”

Section: Discussionsupporting

confidence: 90%

“…We also found a higher prevalence of sacral and femoral involvement (40% each). In our cohort we did not capture any patients with involvement of the small bones of hand, but this has been reported in other studies as a common site of involvement 5,9‐11,19,23‐26 . Similar to our study, treatment has involved use of steroids, methotrexate and hydroxychloroquine, 11 with prednisone and methotrexate appearing most effective in our cohort.…”

Section: Discussionmentioning

confidence: 64%

“…Sarcoid myopathy has been reported to affect 25%‐75% of patients in an asymptomatic manner 5,9,10,19,23,24,26 . Symptomatic sarcoid myopathy has been reported to affect <0.5% or up to 3% of patients with sarcoidosis 21,24,27 .…”

Section: Discussionmentioning

confidence: 99%

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Musculoskeletal sarcoidosis: A single center experience over 15 years

Patil

Hilliard

Arakane³

et al. 2021

Int J of Rheum Dis

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Background Musculoskeletal (MSK) sarcoidosis presents with a variety of clinical phenotypes. Four subtypes of MSK sarcoidosis have been identified to date: Lofgren syndrome, chronic sarcoid arthritis, osseous sarcoidosis, sarcoid myopathy. Each subtype has been reported with varying incidence mainly due to lack of universal classification criteria. Methods We performed a retrospective chart review of patients with MSK sarcoidosis at a single academic center between January 2000 and December 2014. Descriptive statistics were used to describe the proportion of patients with sarcoidosis who had the 4 MSK syndromes of interest, demographic characteristics and therapeutic agents used. Results A cohort of 58 patients with MSK manifestations were identified among 1016 patients with sarcoidosis. Frequency of subtypes include: Lofgren syndrome 46.6%, osseous sarcoidosis 25.9%, chronic sarcoid arthritis 24.1% and sarcoid myopathy 6.9%. The cohort was predominantly female (43/58 patients, 74%) and Caucasian (48/58 patients, 82.8%). Mean age was 47.2 years. One patient had overlap of osseous sarcoidosis and chronic sarcoid arthritis, another patient initially had Lofgren syndrome and later developed chronic sarcoid arthritis. Sarcoid myopathy patients presented with myalgia more often than muscle weakness. Conclusion We identified a large cohort of MSK sarcoidosis and determined the prevalence of all 4 subtypes. In patients who do develop MSK manifestations of sarcoidosis, they are commonly a part of the initial presentation of sarcoidosis. There is an unmet need to establish standardized classification criteria for the 4 MSK sarcoidosis syndromes.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 64%

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Musculoskeletal sarcoidosis: A single center experience over 15 years

Patil

Hilliard

Arakane³

et al. 2021

Int J of Rheum Dis

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“…Pulmonary and extra-pulmonary involvements (skin, bone, bone marrow, SNC, myocardium …) are simultaneously evaluated, with time and cost-saving implications [ 149 , 157 , 166 , 167 ]. Bone biopsy is not necessary in patients with proven disease and typical bone involvement based on [ 18 F]FDG PET/CT or MRI [ 168 ]. [ 18 F]FDG PET/CT may be superior to CT or MRI for detecting bone and bone marrow sarcoidosis [ 169 ].…”

Section: Resultsmentioning

confidence: 99%

State of the art of 18F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation

Casali

Lauri

Altini

et al. 2021

Clin Transl Imaging

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Aim The diagnosis, severity and extent of a sterile inflammation or a septic infection could be challenging since there is not one single test able to achieve an accurate diagnosis. The clinical use of 18F-fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT) imaging in the assessment of inflammation and infection is increasing worldwide. The purpose of this paper is to achieve an Italian consensus document on [ 18 F]FDG PET/CT or PET/MRI in inflammatory and infectious diseases, such as osteomyelitis (OM), prosthetic joint infections (PJI), infective endocarditis (IE), prosthetic valve endocarditis (PVE), cardiac implantable electronic device infections (CIEDI), systemic and cardiac sarcoidosis (SS/CS), diabetic foot (DF), fungal infections (FI), tuberculosis (TBC), fever and inflammation of unknown origin (FUO/IUO), pediatric infections (PI), inflammatory bowel diseases (IBD), spine infections (SI), vascular graft infections (VGI), large vessel vasculitis (LVV), retroperitoneal fibrosis (RF) and COVID-19 infections. Methods In September 2020, the inflammatory and infectious diseases focus group (IIFG) of the Italian Association of Nuclear Medicine (AIMN) proposed to realize a procedural paper about the clinical applications of [ 18 F]FDG PET/CT or PET/MRI in inflammatory and infectious diseases. The project was carried out thanks to the collaboration of 13 Italian nuclear medicine centers, with a consolidate experience in this field. With the endorsement of AIMN, IIFG contacted each center, and the pediatric diseases focus group (PDFC). IIFG provided for each team involved, a draft with essential information regarding the execution of [ 18 F]FDG PET/CT or PET/MRI scan (i.e., indications, patient preparation, standard or specific acquisition modalities, interpretation criteria, reporting methods, pitfalls and artifacts), by limiting the literature research to the last 20 years. Moreover, some clinical cases were required from each center, to underline the teaching points. Time for the collection of each report was from October to December 2020. Results Overall, we summarized 291 scientific papers and guidelines published between 1998 and 2021. Papers were divided in several sub-topics and summarized in the following paragraphs: clinical indications, image interpretation criteria, future perspectivess and new trends (for each single disease), while patient preparation, image acquisition, possible pitfalls and

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“…Furthermore, sarcoidosis can cause a wide variety of musculoskeletal complaints affecting the bones, joints, or muscles with joint involvement manifested as acute or chronic arthritis [109, 137]. Curiously, in Japanese individuals, enlargement of spleen has also reported in a considerable number of patients with sarcoidosis, which was linked to a specific genetic background [129].…”

Section: Main Textmentioning

confidence: 99%

Host-microbe interactions in the pathogenesis and clinical course of sarcoidosis

et al. 2019

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Sarcoidosis is a rare inflammatory disease characterized by the development of granulomas in various organs, especially in the lungs and lymph nodes. Clinics of the disease largely depends on the organ involved and may range from mild symptoms to life threatening manifestations. Over the last two decades, significant advances in the diagnosis, clinical assessment and treatment of sarcoidosis have been achieved, however, the precise etiology of this disease remains unknown. Current evidence suggests that, in genetically predisposed individuals, an excessive immune response to unknown antigen/s is crucial for the development of sarcoidosis. Epidemiological and microbiological studies suggest that, at least in a fraction of patients, microbes or their products may trigger the immune response leading to sarcoid granuloma formation. In this article, we discuss the scientific evidence on the interaction of microbes with immune cells that may be implicated in the immunopathogenesis of sarcoidosis, and highlight recent studies exploring potential implications of human microbiota in the pathogenesis and the clinical course of sarcoidosis.

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Musculoskeletal Manifestations of Sarcoidosis: A Review Article

Cited by 14 publications

References 54 publications

Musculoskeletal sarcoidosis: A single center experience over 15 years

Musculoskeletal sarcoidosis: A single center experience over 15 years

State of the art of 18F-FDG PET/CT application in inflammation and infection: a guide for image acquisition and interpretation

Host-microbe interactions in the pathogenesis and clinical course of sarcoidosis

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