The joint disease of sarcoidosis.

Gumpel, J M; Johns, Carol J.; Shulman, Lawrence

doi:10.1136/ard.26.3.194

Cited by 58 publications

(13 citation statements)

References 25 publications

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“…The clinical characteristics of sarcoid arthritis have been described in several studies. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Based on the clinical course of the disease, two major types of arthritis have been classically distinguished: the acute transient type and the persistent or chronic type. The acute form is the most common rheumatic manifestation of sarcoidosis, often being the presenting manifestation of the disease and generally having a favourable outcome.…”

mentioning

confidence: 99%

Sarcoid arthritis: clinical characteristics, diagnostic aspects, and risk factors

Visser

Vos²,

Zanelli³

et al. 2002

Annals of the Rheumatic Diseases

125

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Objectives: (a) To describe the clinical characteristics of acute sarcoid arthritis and the diagnostic value of its presenting clinical features; (b) to evaluate whether disease onset is seasonal; and (c) to evaluate whether smoking behaviour or the presence of HLA class II alleles is a risk factor for the disease. Methods: 579 consecutive patients with recent onset arthritis who had been newly referred to a rheumatology outpatient clinic were included in a prospective cohort study. The presenting clinical features, the smoking behaviour, and the results of HLA-DQ and HLA-DR DNA typing of 55 patients with sarcoid arthritis, 524 patients with other arthritides of recent onset, and samples of the normal population were compared. Results: In all cases the disease showed a self limiting arthritis and overall good prognosis. The diagnostic ability of a combination of four clinical features-symmetrical ankle arthritis, symptoms of less than two months, age below 40 years, and erythema nodosum-was exceptionally high. When test positivity is defined as the presence of at least three of four criteria the set rendered a sensitivity of 93%, a specificity of 99%, a positive predictive value of 75%, and a negative predictive value of 99.7%. The disease clustered in the months March-July. The disease was negatively associated with smoking (odds ratio (OR) 0.09; 95% confidence interval (95% CI) 0.02 to 0.37) and positively associated with the presence of the DQ2 (DQB1*0201)-DR3 (DRB1*0301) haplotype (OR 12.33; 95% CI 5.97 to 25.48). Conclusion: The disease entity acute sarcoid arthritis has highly diagnostic clinical features. The seasonal clustering, the protective effect of smoking, and the association with specific HLA class II antigens support the hypothesis that it results from exposure of susceptible hosts to environmental agents through the lungs.

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mentioning

confidence: 99%

Sarcoid arthritis: clinical characteristics, diagnostic aspects, and risk factors

Visser

Vos²,

Zanelli³

et al. 2002

Annals of the Rheumatic Diseases

125

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“…This symptom occurred in nearly 20% of an unselected sarcoid clinic population at Johns Hopkins (13). As in other descriptions of the syndrome (9,14,15, IS), early cases with fever, bilateral hilar lymphadenopathy, erythema nodosum, and peripheral lymphadenopathy were predominant.…”

Section: Discussionmentioning

confidence: 61%

Extensive phalangeal cystic lesions

Schriber

Firooznia

1975

Arthritis & Rheumatism

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A young black man is presented with a 33-month course of insidious but eventually striking hand deformity and limitation of motion in the absence of any other symptoms. Radiologic and histologic findings of the digits support the diagnosis of sarcoidosis, though physical, laboratory, and chest x-ray examination show no evidence of this multisystem disease.Osseous involvement is a well-recognized feature of sarcoidosis, occurring rarely in the absence of skin lesions or chronic, multiorgan system involvement. When present it is usually not symptomatic. A patient was presented with complaints limited to the hands and feet throughout a 33-month course. The possibility is raised that, in rare instances, sarcoid may be limited to the skeletal system. The patient was well until January 1971 when he noted swelling and mild discomfort in the area of the second left metacarpophalangeal joint, which lasted several days and resolved. This condition recurred soon afterward in several areas of both hands. At all times, swelling was the predominant feature, although there was mild discomfort at times, especially in the morning. He came to the outpatient department at Bellevue Hospital in early 1971 for this complaint. Radiographic examination of the hands showed several cystic bony lesions, but the patient did not return for further workup or treatment. CASE REPORTDuring the next 19 months he noted persistent swelling of the fingers with occasional mild discomfort and morning stiffness. However, he was not greatly bothered and continued his activities as a student, even playing basketball occasionally. He sought no medical attention during this time. I n the summer of 1972, the patient noted that the swelling increased and that he now had difficulty performing certain fine movements because of relatively painless limited motion. When school started in September 1972, he noted he could not hold a pencil properly and sought medical attention for the second time at Bellevue Hospital. Pain was never a major feature and there were no acute at tacks.There was no history of fever, malaise, rash, other musculoskeletal complaints, visual disturbances, cough, or shortness of breath. Past medical history and family history were noncontributory. On admission to Bellevue Hospital in September 1972, physical examination revealed a wellnourished, well-developed black man who appeared healthy, except for obviously swollen, sausage-like fingers. Vital signs, head, eyes, ears, nose, and throat were normal. There were no skin lesions. There were several y2 X v2 cm soft, movable, nontender nodes in both axillae. The chest cage, heart, and lungs were normal. The abdomen showed no organo-

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“…active and passive movement of the involved joints without weight-bearing causes little added discomfort." Gumpel and associates (16) described similar findings at the ankle in their 1967 review of ,the joint disease of erythema nodosum.…”

Section: Discussionmentioning

confidence: 73%

Periarticular inflammation, bilateral hilar adenopathy and a sarcoid reaction

Caplan

Katz

Rubenstein

1970

Arthritis & Rheumatism

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A total of 19 cases of bilateral hilar adenopathy in association with polyarthritis are presented. Erythema nodosum, usually occurring in this syndrome, was not present; however, marked periarticular inflammation of the ankles with little pain on motion was noted and served as the initial clue to the diagnosis. All patients had elevated sedimentation rates; hyperglobulinemia and positive tests for rheumatoid factor were frequently found. A sarcoid reaction was seen in 73% of the patients whose tissue was examined histologically. Diagnosis was established by the radiologic demonstration of bilateral hilar adenopathy. Prognosis was favorable. The etiology of the disorder is unknown, and its relationship to Boeck's sarcoidosis Is uncertaian.

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The joint disease of sarcoidosis.

Cited by 58 publications

References 25 publications

Sarcoid arthritis: clinical characteristics, diagnostic aspects, and risk factors

Sarcoid arthritis: clinical characteristics, diagnostic aspects, and risk factors

Extensive phalangeal cystic lesions

Periarticular inflammation, bilateral hilar adenopathy and a sarcoid reaction

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