American Journal of Roentgenology

1988

DOI: 10.2214/ajr.150.1.161

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Osteosclerotic sarcoidosis

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Abstract: The laboratory studies showed an increased alkaline phosphatase of 523 units, a total protein of 8.2 mg, and a globulin of 4.4 mg. The cholesterol level was 159 mg/dl. The hemoglobin was 13.1 g, and

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Epidemiology and Prevalence Of Osseous Sarcoid1

Radiographic Features1

Discussion1

Clinical Impact1

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Cited by 15 publications

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“…83,110 Extension of the granulomatous process into the cortex may cause bone destruction or resorption; osteosclerotic lesions are rare. 83,102,110,111 The periosteum and articular cartilage are usually spared. 110 Most commonly, sarcoidosis affects the small bones, particularly the middle and distal phalanges of the hands and feet, although any part of the axial or appendicular skeleton may be involved.…”

Section: Epidemiology and Prevalence Of Osseous Sarcoidmentioning

confidence: 99%

“…Osteosclerosis occurs less frequently than osteolysis. 83,111,112 Generalized osteosclerosis affects the long bones and vertebrae more commonly than the small bones of the hands and feet. When osteosclerosis is seen in the small bones, there are nodular opacities within the medullary cavity.…”

Section: Radiographic Featuresmentioning

confidence: 99%

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Sarcoidosis Involving the Musculoskeletal System

2002

Seminars in Respiratory and Critical Care Medicine

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Although sarcoidosis can affect virtually any organ, musculoskeletal involvement is infrequent. Early in the course of the disease, acute polyarthritis may be observed in up to 40% of patients, but this is often self-limited. Chronic or recurrent sarcoid arthritis is rare, affecting only 1 to 4% of patients. Asymptomatic involvement of muscles has been reported in 25 to 75% of patients in small series, but symptomatic involvement of muscles is rare. Although prospective studies assessing the prevalence of muscle involvement in sarcoidosis have not been done, several large retrospective studies suggest that symptomatic muscle involvement occurs in < 0.5% of patients with sarcoidosis. Patterns of sarcoid muscle involvement include chronic, progressive myopathy; nodular or tumorous sarcoidosis affecting muscles; and an acute polymyositis-like syndrome. Corticosteroid therapy is usually efficacious for the acute myositis variant but is less consistently helpful in the other forms (e.g., chronic myopathy or nodules). Similarly, clinically significant involvement of bone is rare (< 2-5%), and is often associated with chronic multisystemic disease, lupus pernio, and chronic uveitis. Unfortunately, osseous sarcoidosis is often unresponsive to therapy. In this review, we discuss the prevalence, clinical features, and management of sarcoidosis involving muscle, joints, and bones.

“…83,110 Extension of the granulomatous process into the cortex may cause bone destruction or resorption; osteosclerotic lesions are rare. 83,102,110,111 The periosteum and articular cartilage are usually spared. 110 Most commonly, sarcoidosis affects the small bones, particularly the middle and distal phalanges of the hands and feet, although any part of the axial or appendicular skeleton may be involved.…”

Section: Epidemiology and Prevalence Of Osseous Sarcoidmentioning

confidence: 99%

“…Osteosclerosis occurs less frequently than osteolysis. 83,111,112 Generalized osteosclerosis affects the long bones and vertebrae more commonly than the small bones of the hands and feet. When osteosclerosis is seen in the small bones, there are nodular opacities within the medullary cavity.…”

Section: Radiographic Featuresmentioning

confidence: 99%

Sarcoidosis Involving the Musculoskeletal System

2002

Seminars in Respiratory and Critical Care Medicine

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Although sarcoidosis can affect virtually any organ, musculoskeletal involvement is infrequent. Early in the course of the disease, acute polyarthritis may be observed in up to 40% of patients, but this is often self-limited. Chronic or recurrent sarcoid arthritis is rare, affecting only 1 to 4% of patients. Asymptomatic involvement of muscles has been reported in 25 to 75% of patients in small series, but symptomatic involvement of muscles is rare. Although prospective studies assessing the prevalence of muscle involvement in sarcoidosis have not been done, several large retrospective studies suggest that symptomatic muscle involvement occurs in < 0.5% of patients with sarcoidosis. Patterns of sarcoid muscle involvement include chronic, progressive myopathy; nodular or tumorous sarcoidosis affecting muscles; and an acute polymyositis-like syndrome. Corticosteroid therapy is usually efficacious for the acute myositis variant but is less consistently helpful in the other forms (e.g., chronic myopathy or nodules). Similarly, clinically significant involvement of bone is rare (< 2-5%), and is often associated with chronic multisystemic disease, lupus pernio, and chronic uveitis. Unfortunately, osseous sarcoidosis is often unresponsive to therapy. In this review, we discuss the prevalence, clinical features, and management of sarcoidosis involving muscle, joints, and bones.

“…Both factors can increase PKC activity and do so without causing a translocation of cytosolic PKC to the membrane (62,63). Both factors increase synthesis of plasma membrane PKC, and the major isoform affected is PKC␣.…”

Section: Discussionmentioning

confidence: 99%

The Synergistic Effects of Vitamin D Metabolites and Transforming Growth Factor-β on Costochondral Chondrocytes Are Mediated by Increases in Protein Kinase C Activity Involving Two Separate Pathways*

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et al. 1998

Endocrinology

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Transforming growth factor-␤ (TGF␤), as well as the vitamin D 3 metabolites 1,25-dihydroxyvitamin D 3 (1,25) and 24,25-dihydroxyvitamin D 3 (24,25), regulate chondrocyte differentiation and maturation during endochondral bone formation. Both the growth factor and secosteroids also affect protein kinase C (PKC) activity, although each has its own unique time course of enzyme activation. Vitamin D 3 metabolite effects are detected soon after addition to the media, whereas TGF␤ effects occur over a longer term. The present study examines the interrelation between the effects of 1,25, 24,25, and TGF␤ on chondrocyte differentiation, matrix production, and proliferation. We also examined whether the effect is hormone-specific and maturation-dependent and whether the effect of combining hormone and growth factor is mediated by PKC.This study used a chondrocyte culture model developed in our laboratory that allows comparison of chondrocytes at two stages of differentiation: the more mature growth zone (GC) cells and the less mature resting zone chondrocyte (RC) cells. Only the addition of 24,25 with TGF␤ showed synergistic effects on RC alkaline phosphatasespecific activity (ALPase). No similar effect was found when 24,25 plus TGF␤ was added to GC cells or when 1,25 plus TGF␤ were added to GC or RC cells. The addition of 1,25 plus TGF␤ and 24,25 plus TGF␤ to GC and RC cells, respectively, produced a synergistic increase in [ 35 S]sulfate incorporation and had an additive effect on [ 3 H]thymidine incorporation. To examine the signal transduction pathway involved in producing the synergistic effect of 24,25 and TGF␤ on RC cells, the level of PKC activity was examined. Addition of 24,25 and TGF␤ for 12 h produced a synergistic increase in PKC activity. Moreover, a similar effect was found when 24,25 was added for only the last 90 min of a 12-h incubation. However, a synergistic effect could not be found when 24,25 was added for the last 9 min or the first 90 min of incubation. To further understand how 24,25 and TGF␤ may mediate the observed synergistic increase in PKC activity, the pathways potentially leading to activation of PKC were examined. It was found that 24,25 affects PKC activity through production of diacylglycerol, not through activation of G protein, whereas TGF␤ only affected PKC activity through G protein.The results of the present study indicate that vitamin D metabolites and TGF␤ produced a synergistic effect that is maturationdependent and hormone-specific. Moreover, the synergistic effect between 24,25 and TGF␤ was mediated by activation of PKC through two parallel pathways: 24,25 through diacylglycerol production and TGF␤ through G protein activation. (Endocrinology 139: 534 -545, 1998)

“…Nevertheless, it may show that the small bones of the hands and feet are affected frequently, especially the middle and distal phalanges 60. Scattered osteosclerotic changes may also be noted in the skull, long bones, ribs or elsewhere, and may be an occasional finding of a total body scan with gallium-67 (fig 1).…”

Section: Clinical Impactmentioning

confidence: 98%

Clinical impact of bone and calcium metabolism changes in sarcoidosis

1998

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