Clinical Characteristics of Sarcoid Arthropathy: A Population‐Based Study

Abstract

Objective The epidemiology and clinical characteristics of sarcoid arthropathy are not well-described as only referral-based studies have been reported. This study aimed to use the data from a geographically well-defined population to characterize the clinical characteristics of sarcoid arthropathy. Methods An inception cohort of patients with incident sarcoidosis in 1976–2013 in a geographically well-defined population was identified based on comprehensive individual medical record review. Inclusion required physician diagnosis supported by histopathology and radiologic features of intrathoracic sarcoidosis, compatible clinical presentation, and exclusion of other granulomatous diseases. Patients with joint pain were then identified from this cohort. Results In 1976–2013, all 345 incident cases of sarcoidosis were identified. Symptoms of joint pain occurred in 42 patients (mean age 41.2 years, 57.1% female and 95% Caucasian), and 35 patients had swollen joint(s) on physical examination. Most patients had arthralgia prior to the diagnosis of sarcoidosis with an average time to diagnosis of 21 days. Of the 35 cases, oligoarthritis (two to four joints) was the most common pattern (88% of cases) followed by monoarthritis (6%) and polyarthritis (6%). Ankles were involved in 91% of cases. In the majority of patients (88%), the arthritis resolved within 6 weeks. The classic Lofgren syndrome was observed in 11 patients (26%). Conclusion Inflammatory arthritis occurs in a minority of patients with sarcoidosis. Acute oligoarthritis with bilateral ankles involvement was the most common pattern of sarcoid arthropathy. It should be noted that the generalizability of the results may be limited as the cohort was predominantly Caucasian.

Sternoclavicular joint arthritis as the initial presentation of sarcoidosis

“…Ankle joint involvement is the most frequent in acute sarcoid arthritis, followed by knee, wrist, and metacarpophalangeal joint involvement (3,8). Axial joint, including costochondral and chondrosternal joints, involvement and sacroiliitis is rare in sarcoidosis (3,4,8). However, sternoclavicular joint involvement, to the best of our knowledge, has never been described in sarcoid arthropathy.…”

“…Musculoskeletal involvement usually occurs in the form of acute, self-limited polyarthritis, observed in up to 40% patients, whereas chronic or recurrent sarcoidosis is rarely observed, affecting only 1%-4% patients (1,2). Arthritis in sarcoidosis is usually peripheral, affecting bilateral small and large joints in a symmetrical fashion, whereas axial skeleton involvement is rare (3,4). We report on a middle-aged female with sternoclavicular joint arthritis as her initial presentation of sarcoidosis.…”

Epidemiology and clinical characteristics of sarcoidosis: an update from a population-based cohort study from Olmsted County, Minnesota

“…Arthropathy was the second most common extra-thoracic disease manifestation of sarcoidosis in this cohort with joint pain occurring in 12% and swollen joints occurring in 10% of patients with sarcoidosis (25). Oligoarthritis was by far the most common pattern of joint involvement (88%).…”

“…The outcome of sarcoid arthropathy is good as the majority of patients (88%) achieved complete remission within 6 weeks. Most patients with active joint disease were treated with a short duration of non-steroidal anti-inflammatory drugs (NSAIDs) and/or oral glucocorticoids (25). …”

Reply

“…We read the article published recently in Arthritis Care & Research by Ungprasert et al (1) with great interest. The authors have mentioned that their observations may not be generalizable, as their cohort included mostly white patients.…”