Solitary osseous sarcoidosis: a rare reason for pathologic fracture

Abstract

Sarcoidosis with osseous involvement as the initial manifestation is rare. Due to lack of other organ involvements, the diagnosis is somehow difficult to establish. We report a case with osseous sarcoidosis as the initial and major manifestation that developed spontaneous bone fracture. Our case emphasizes the importance of histological evidence and exclusion of other diseases i.e. rheumatoid arthritis, before making the diagnosis of osseous sarcoidosis.

Osseous sarcoidosis: A multicenter retrospective case-control study of 48 patients

“…Glucocorticoid therapy was the most frequently used treatment (1,5,14). Glucocorticoids were very effective in providing symptomatic relief, but they have been shown to result in persistent radiographic abnormalities despite clinical resolution (20). In their literature review, Gowani et al found that glucocorticoids were used in 70 out of 95 patients with osseous sarcoidosis, with all cases reporting clinical improvement and half of the cases radiographic improvement (14).…”

Risk of vertebral and non-vertebral fractures in patients with sarcoidosis: a population-based cohort

“…Sarcoidosis can also be localised in bone, as has been demonstrated by a study with PET scans which show extensive bone marrow involvement in sarcoidosis [ 46 ]. Sarcoid granulomas are surrounded by osteoclasts, but a local focus of osseous sarcoidosis resulting in a fracture is rare [ 47 ]. Pulmonary Wnt signalling is altered in patients with sarcoidosis [ 48 ]; however, whether Wnt signalling in bone is also altered in patients with sarcoidosis is unknown.…”

Osseous Sarcoidosis Revealed by a Pathologic Fracture and Successfully Treated With Methotrexate and Prednisone

“…Bone involvement is typically associated with pulmonary involvement and skin lesions . Pathologic fractures caused by osseous sarcoidosis are rare , but this diagnosis should be considered in cases of lytic bone lesions.…”